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Pharmacology A Nursing Process Approach 7th Edition by Kee – Hayes – McCuistion – Test Bank 

Kee: Pharmacology, 7th Edition

 

Chapter 1: Drug Action: Pharmaceutic, Pharmacokinetic, and Pharmacodynamic Phases

 

Test Bank

 

              MULTIPLE CHOICE

 

  1. A nurse is providing an oral medication for pain relief to a client. To attain the fastest pain relief, the nurse administers the medication so that it is most rapidly absorbed from the gastrointestinal (GI) tract. Which mode of delivery has the fastest absorption?
a. Tablet
b. Enteric-coated pill
c. Capsule
d. Liquid suspension

 

 

 

  1. A client asks why she needs to take a medication on an empty stomach. The nurse explains that food generally has which effect on drug dissolution and absorption?
a. Enhances
b. Increases
c. Decreases
d. Does not have an effect

 

 

 

  1. Biotransformation is affected by many factors. What happens to the client’s drug metabolism when liver function is decreased?
a. The client can develop toxicity.
b. The client will have an enhanced therapeutic response.
c. The client may require a larger than normal dose of the medication.
d. The client will experience a decreased therapeutic response.

 

 

  1. A client asks why the oral dose of her pain medication is higher than the intravenous dose. The nurse explains that with the oral dose, only 20% to 40% of the drug may actually enter systemic circulation. This reduces the amount of active drug. What is the term for this effect?
a. Protein binding
b. Bioavailability
c. Hepatic first pass
d. Pinocytosis

 

 

 

  1. When providing a medication, which route should the nurse select to ensure the maximum amount of bioavailability?
a. Oral
b. Intravenous
c. Intramuscular
d. Subcutaneous

 

 

 

  1. A client is being given two highly protein-bound drugs concurrently. What is most likely to be the result of this administration?
a. More free drug in circulation
b. Less free drug in circulation
c. More drug bound to protein
d. More drug excreted in the urine

 

 

 

  1. A client is taking a drug that is moderately highly protein bound. Several days later, the client takes a second drug that is 90% protein bound. What is most likely to have occurred as a result of this administration?
a. The first drug remains protein bound.
b. The first drug becomes increasingly inactive.
c. The first drug is released from the protein and becomes more pharmacologically active.
d. The second drug becomes more active.

 

 

 

  1. A nurse is determining whether a medication is ordered to be given at the appropriate intervals. This is done by assessing the half-life of the medication. The serum half-life (t) of a drug is the time required:
a. for half of a drug dose to be absorbed.
b. after absorption for half of the drug to be eliminated.
c. for a drug to be achieve maximum effectiveness.
d. for half of the drug dose to be completely distributed.

 

 

 

  1. A client is to receive a drug that has a half-life of 36 hours. The drug would probably be administered on which dose schedule?
a. Once a week
b. Once a day
c. Twice a day
d. Three times a day

 

 

 

  1. A client is suffering from end-stage renal disease. Because of this condition, the nurse monitors drug levels to assess for which phenomenon?
a. Toxicity
b. Subtherapeutic levels
c. Drug ineffectiveness
d. Poor compliance

 

 

 

  1. A client’s creatinine clearance level is 105 mL/min. Based on this information, what type of change in his medication should the nurse anticipate?
a. Increased dosage
b. Decreased dosage
c. Unchanged dosage
d. Dosage withheld

 

 

 

  1. Isoproterenol (Isuprel) is an example of a medication that enhances the beta receptors in the body. What is the term for drugs that stimulate a response?
a. Antagonists
b. Agonists
c. Depressants
d. Therapeutic effect

 

 

 

  1. A nursing role is to teach clients to watch for adverse medication reactions. The client should be able to recognize what about adverse reactions?
a. They are mild, easily treatable side effects.
b. They are therapeutic, expected effects.
c. They are undesired effects that may be severe.
d. They are the desired therapeutic effects.

 

 

 

  1. The nurse teaches the client that undesired effects are frequently associated with a client stopping a medication before completion of the full course. The nurse should also instruct the client that physiologic effects not related to the desired effect, which can be predicted or associated with the use of the drug, may also occur. What should the client recognize about these physiologic effects?
a. They are severe adverse reactions.
b. They are side effects.
c. They are synergistic effects.
d. They are toxic effects.

 

 

 

  1. A nurse is learning how to draw peak and trough levels of a medication. In order to draw them correctly, the nurse should know what the trough level is. The trough level is the __________ of a drug.
a. minimum effective concentration
b. highest plasma concentration
c. lowest plasma concentration
d. rate of absorption

 

 

 

  1. The client is receiving frequent daily drug dosing of a drug that has a long duration of action. What should the nurse expect to be the result of this administration?
a. Drug accumulation and possible drug toxicity
b. Increased drug excretion
c. Enhanced therapeutic response
d. Increased drug half-life

 

 

 

  1. The nurse notes that the client is rapidly developing a decreased response to a medication. This decreased response is known as:
a. pharmacogenetics.
b. tachyphylaxis.
c. drug accumulation.
d. drug toxicity.

 

 

 

  1. Because of hereditary influence, drug action may vary from a predicted drug response. This variance is known as:
a. biotransformation.
b. tachyphylaxis.
c. pharmacogenetics.
d. transcription factors.

 

 

 

  1. The nurse is monitoring a patient prescribed an aminoglycoside antibiotic for toxicity. Which nursing intervention is indicated when administering this medication?
a. Ensure that the client voids before administration.
b. Have emergency airway equipment at the bedside.
c. Monitor blood levels of the medication.
d. Determine liver function before each dose.

 

 

 

  1. The nurse sees that the client has been prescribed a loading dose of medication. What effect should the nurse expect to result from the client receiving a loading dose?
a. A rapid maximum effective concentration
b. Maintenance dose the lowest plasma concentration of the drug
c. Therapeutic dose the highest plasma concentration of the drug
d. A rapid minimum effective concentration

 

 

 

  1. The nurse receives the results of laboratory testing and sees that the level of valproic acid in the client’s blood is 78 mcg/mL. What is the nurse’s most appropriate response?
a. The nurse must call the physician immediately; this is a toxic level of medication.
b. He or she must do nothing; this is a therapeutic level of medication.
c. He or she must call the physician; this is a dangerously high level of medication.
d. The nurse must do nothing; this is a subnormal level of medication.

 

 

 

  1. The nurse is caring for a client who needs to have a peak drug level drawn. He was given the oral medication 30 minutes ago. What is the best action on the part of the nurse?
a. Call the lab to have the medication level drawn immediately.
b. Arrange for the level to be drawn tomorrow since the peak time has passed.
c. Wait for at least another 30 minutes before calling to have the level drawn.
d. Schedule the level to be drawn in 8 hours.

 

 

 

  1. The client has been prescribed digoxin. Before administering the drug on a routine basis to the client, the nurse should recognize that the client should receive a _____ dose.
a. therapeutic
b. peak
c. trough
d. loading

 

 

 

  1. The client has been placed on an enteric-coated medication. An appropriate action on the part of the nurse is to instruct the client to __________ the medication.
a. weigh herself at the same time every day while on
b. drink at least eight glasses of water daily while on
c. adhere to a low-sodium diet while on
d. avoid eating fatty food before taking

 

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 2: Nursing Process and Client Teaching

 

Test Bank

 

MULTIPLE CHOICE

 

  1. Which is the sequence of steps in the nursing process?
a. Implementation, evaluation, planning, assessment
b. Planning, assessment, implementation, evaluation
c. Assessment, planning, implementation, evaluation
d. Evaluation, implementation, assessment, planning

 

 

 

  1. The client’s knowledge base about the drugs used is part of the:
a. plan.
b. analysis.
c. subjective database.
d. objective database.

 

 

 

 

  1. Attainment of goals is associated with which phase of the nursing process?
a. Implementation
b. Planning
c. Assessment
d. Evaluation

 

 

 

  1. During which phase of the nursing process would the nurse identify client perceptions and expectations of the drug’s effectiveness?
a. Planning
b. Assessment
c. Evaluation
d. Implementation

 

 

 

  1. The nurse is establishing goals for a client related to medication administration. Which of the phases of the nursing process is characterized by goal setting?
a. Planning
b. Evaluation
c. Implementation
d. Assessment

 

 

 

  1. During which phase of the nursing process will the nurse include nursing actions or interventions necessary to accomplish expected outcomes?
a. Assessment
b. Planning
c. Implementation
d. Evaluation

 

 

 

 

 

  1. Which is a correctly written goal?
a. The client will independently administer a prescribed dose of antibiotic by the end of the first teaching session.
b. The client will learn to take an antibiotic correctly.
c. The client will administer a prescribed dose.
d. The client will know how to administer antibiotics.

 

 

 

  1. Upon physical assessment, a nurse notes that a client has visual impairment. The nurse is concerned that the client’s visual changes may affect her ability to self-administer medications. Which nursing diagnosis best describes this situation?
a. Risk for ineffective therapeutic regimen management related to medication secondary to visual impairment
b. Deficient knowledge related to medication administration
c. Ineffective family therapeutic regimen management related to visual impairment
d. Ineffective coping related to lack of ability to self-administer medications

 

 

 

  1. During assessment, a client reports a reaction to a medication. What is the next nursing intervention?
a. Let the physician know that the client cannot receive the medication.
b. Ask the client the type of reaction experienced.
c. Reassure the client that the reaction will not occur again.
d. Note the comment in the client’s chart and give the medication.

 

 

 

  1. A nurse is caring for a client who takes a chewable medication. The client does not take the medication because his teeth and gums have pain when chewing. The nurse establishes the following nursing diagnosis for the client: impaired dentition related to chronic gum inflammation secondary to poor dental hygiene. Which nursing goal is most appropriate for the client?
a. The client will verbalize the pathophysiology of gum disease.
b. The client will demonstrate the procedure for brushing teeth.
c. The client will understand the need for dental hygiene.
d. The client will discuss the reasons dental hygiene is important.

 

 

 

  1. A nurse is teaching a client about a medication that is scheduled to be administered q.i.d. The client states that she does not use a watch or clock and lives without a daily routine. Which teaching would be most helpful for the client?
a. Instruct the client to take the medication each morning and evening when brushing her teeth.
b. Teach the client to take the medication at lunch every day.
c. Provide the client with a watch to ensure she takes the medication at correct times.
d. Instruct the client to take the medication with meals and at bedtime each day.

 

 

 

 

  1. A nurse is teaching a client about his medications. In his care plan, a previous nurse indicated that the client was a visual learner. Which teaching strategy would be indicated for this client?
a. Pamphlets or videos about the medication
b. Opportunities for practicing the administration of medication
c. A discussion about the medication
d. An audiotape describing the medication and its actions

 

 

  1. A nurse is establishing a plan of care for a client who has been ordered to receive antibiotic therapy. The client does not read English but is able to understand spoken English. She is of a lower-income socioeconomic group. Which strategy would be most appropriate for teaching this client?
a. Provide a video going over the information.
b. Give the client several pamphlets and asking her to go over them with her family.
c. Provide a teaching sheet with simple words and pictures.
d. Arrange a quiet time to discuss the medication regimen with the client.

 

 

 

  1. A client with AIDS-defined disease is ordered to receive two different medications. The primary care nurse notes that he has not been taking his medications as ordered. The client says, “I don’t like the side effects of the drugs.” Which is an appropriate nursing diagnosis?
a. Knowledge deficit related to progression of the AIDS disease
b. Grieving related to diagnosis of terminal disease
c. Risk for infection related to impaired immune function
d. Noncompliance related to medication side effects and lack of knowledge

 

 

 

  1. The nurse is working with an Asian client to provide instruction regarding his medication regimen. The nurse is planning to provide the client with pamphlets to take with him as part of the follow-up to his instructional sessions. What is the most appropriate action on the part of the nurse?
a. Make prolonged eye contact with the client.
b. Use both hands as a show of respect.
c. Show flexibility in making follow-up appointments.
d. Speak clearly in a loud voice.

 

 

 

  1. The nurse has decided to add a nursing diagnosis to the client’s drug therapy plan of care that represents wellness/health promotion. What is the most appropriate diagnosis to add to promote these areas?
a. Ineffective health maintenance related to not having recommended preventive care
b. Risk for injury related to side effect if drugs
c. Therapeutic regimen management, readiness for enhanced
d. Ineffective therapeutic regimen management related to lack of finances

 

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 3: Medication Safety

 

Test Bank

 

MULTIPLE CHOICE

 

  1. What is the importance of the nurse practicing the “5-plus-5 rights” of drug administration?
a. They ensure correct mixing of the drug.
b. They ensure safe drug administration.
c. They ensure time-saving administration.
d. They ensure adequate knowledge about the drug.

 

 

 

  1. “Give Tylenol 650 mg q3-4h as needed for headache” is an example of which category of drug order?
a. Standing drug order
b. One-time drug order
c. PRN
d. STAT

 

 

 

  1. A nurse is administering a medication to a client. The nurse tells the client the rationale for the medication. This nurse is observing which client right?
a. The right to informed consent
b. The right to permission
c. The right to ethics
d. The right to autonomy

 

 

 

  1. A nurse is ordered to administer a medication via the sublingual route. The nurse correctly places the medication:
a. in the buccal mucosa.
b. under the tongue.
c. between the teeth and gums.
d. in a cup of water to dissolve.

 

 

 

  1. The nurse is calculating the dosage of a drug to administer. Once the dosage has been calculated, what is the most important action on the part of the nurse?
a. Contact the pharmacist for dosage confirmation.
b. Check the identity of the patient three times.
c. Recalculate the drug dose and check with another nurse.
d. Check the American Hospital Formulary for drug doses.

 

 

 

  1. The nurse is preparing to administer tetracycline to the client. What is the most appropriate time for the client to receive this medication?
a. One hour before dinner in the evening
b. With breakfast in the morning
c. With a late-afternoon snack
d. Directly after lunch in the mid-afternoon

 

 

 

  1. The nurse checks the expiration date on the medication to be administered and finds that the drug expired 2 days ago. What is the most appropriate action on the part of the nurse?
a. Hold one dose of the medication.
b. Return the medication to the pharmacy.
c. Contact the physician for orders.
d. Administer the drug but monitor the client.

 

 

 

  1. The nurse notes that the client is scheduled to receive a dose of potassium. What is the most appropriate time for the client to receive this medication?
a. Directly after dinner in the evening
b. One hour before lunch in late morning
c. With water only in the late afternoon
d. First thing after rising in the morning

 

 

 

  1. The nurse verifies that he is using only standardized abbreviations in documenting medication information. He recognizes that this fulfills which of the National Patient Safety Goals?
a. Improve the accuracy of patient identification.
b. Improve the effectiveness of communication among caregivers.
c. Improve the safety of using medications.
d. Accurately and completely reconcile medications across the continuum of care.

 

 

 

  1. The nurse ensures that she provides the next nurse taking over the care of her client with a complete list of his medications since the next nurse is newly admitted to that unit. She recognizes that this fulfills which of the National Patient Safety Goals?
a. Improve the accuracy of patient identification
b. Improve the effectiveness of communication among caregivers
c. Improve the safety of using medications
d. Accurately and completely reconcile medications across the continuum of care

 

 

 

  1. The client is scheduled to receive Protonix as part of his medication regimen. The most important teaching intervention to be implemented by the nurse is to instruct the client:
a. on the proper way to split the tablet.
b. to crush the tablet before swallowing.
c. to avoid crushing the tablet.
d. to swallow the tablet with a minimum of water.

 

 

 

  1. The client has been on an oral dose of a medication. The nurse recognizes that the client is experiencing difficulty swallowing. What is the most important action on the nurse’s part?
a. Crush the medication and mix it with water.
b. Split the medication in half and mix it in jelly.
c. Call the physician for a liquid version of the medication.
d. Tell the pharmacy to hold the medication until further notice.

 

 

 

  1. The nurse is caring for an older adult client who is scheduled to receive a dose of barbiturates. Based on the nurse’s knowledge of how the older adult client responds to these medications, the nurse should expect the dosage to be:
a. lower than normal.
b. higher than normal.
c. divided in half.
d. unchanged.

 

 

 

  1. The nurse is calculating a dosage of medication for an infant. The nurse recognizes that the dosage is based on the infant’s:
a. biological age.
b. weight in pounds.
c. gestational age.
d. weight in kilograms.

 

 

 

  1. The nurse is caring for a thin-framed adult who is scheduled to receive multiple doses of antineoplastic medication. The nurse should expect the dosage for this person to be:
a. lower than normal.
b. higher than normal.
c. divided in half.
d. unchanged.

 

 

 

Chapter 4: Medication Administration

 

Test Bank

 

MULTIPLE CHOICE

 

  1. The nurse is preparing to administer an intramuscular injection to an infant. What is the most accurate site for the nurse to select for this administration?
a. Ventrogluteal
b. Vastus lateralis
c. Dorsogluteal
d. Deltoid

 

 

 

  1. What is an appropriate nursing intervention to use to meet the psychiatric needs of a hospitalized infant?
a. Move slowly while conducting care.
b. Explain procedures carefully.
c. Use the oral route for medications.
d. Allow the child to express feelings.

 

 

 

  1. During administration of eye drops, the nurse should teach the client to prevent systemic absorption of the drug by performing which action?
a. Use the ointment form of the drug.
b. Apply the drug directly on the cornea.
c. Have the client look straight ahead.
d. Gently press on the lacrimal duct.

 

 

 

  1. A nurse is preparing to administer a deep IM injection to a client. Which site is suited for a deep IM injection?
a. Abdomen
b. Dorsogluteal
c. Deltoid
d. Vastus lateralis

 

 

 

  1. A nurse administers an injection using the Z-track method. The nurse instructs the patient that the Z-track technique is designed to accomplish what?
a. Allow the client to accept at least 5 mL of medication.
b. Prevent medication from leaking into subcutaneous tissue.
c. Decrease the possibility of “self-sticks.”
d. Take less time to administer.

 

 

 

  1. A nurse is applying nitroglycerin ointment to a client. When applying medication topically, what is the highest priority nursing intervention?
a. Apply medication liberally.
b. Avoid contact of the medication with the nurse’s skin.
c. Massage the area.
d. Have client apply medication.

 

 

 

  1. A nurse prepares to administer an ear medication to a 2-year-old child. What is the correct action by the nurse?
a. Position the child with the ear down on the bed.
b. Pull the ear upward and backward.
c. Put the child in high-Fowler’s position.
d. Pull the ear downward and backward.

 

 

 

  1. The nurse is teaching the client how to administer a sublingual tablet in the home setting. What is the highest priority instruction?
a. Take nothing by mouth for one hour before taking the medication.
b. Avoid taking fluid with the medication.
c. Gently place the tablet between the teeth and gums.
d. Take the medication with food so as to avoid gastrointestinal irritation.

 

 

 

  1. A client has been using his inhaler at home. He tells the nurse that “the medication doesn’t seem to work as well as it did.” What should the nurse assess for first?
a. Tolerance to the medication
b. Unhealthy drug-seeking behaviors
c. Physical addiction
d. Poor tolerance of pain

 

 

  1. A client with chronic angina is ordered to receive nitroglycerin via patch. What is the highest priority nursing action regarding this method of administration?
a. Cut the patch to provide the correct dose of medication.
b. Use sterile technique when applying the patch.
c. Remove the old patch before applying the new patch.
d. Cover the patch with an airtight dressing after application.

 

 

 

  1. A nurse is administering an intradermal PPD to test for client exposure to the tuberculosis bacterium. Which method is the correct one for administering this injection?
a. Use a 5-degree angle to insert a 20-gauge needle.
b. Use a 10-degree angle to insert a 25-gauge needle.
c. Use a 45-degree angle to insert a 26-gauge needle.
d. Use a 90-degree angle to insert an 18-gauge needle.

 

 

 

  1. A client returns to the nursing unit from conscious sedation after having a fracture set and placed in a cast. The client expresses pain 3 hours after the procedure. The choice of medication and route will be based on which information?
a. The client should not receive pain medication because of his previous sedation.
b. The client will need to void before receiving any pain medication in order to avoid urinary retention.
c. The client should receive intravenous medication only for pain because of the operative procedure.
d. The client’s ability to swallow should be evaluated before he or she receives oral medication.

 

 

 

  1. The nurse is preparing to administer a subcutaneous injection of morphine sulfate (MSO4) to a client. The client’s height, weight, and muscle mass are within normal limits. What are the appropriate needle size and angle for this injection?
a. 27-gauge needle, 10-degree angle
b. 20-gauge needle, 90-degree angle
c. 23-gauge needle, 20-degree angle
d. 25-gauge needle, 45-degree angle

 

 

 

MULTIPLE RESPONSE

 

  1. The nurse is preparing to administer an ointment to the client’s eye and is gathering the needed supplies. What supplies are needed to complete this task? (Select all that apply.)
a. Clean gloves
b. Medication ointment
c. Sterile gauze
d. Sterile gloves
e. 30-mL syringe
f. 5-mL syringe
g. Tissues

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 5: Medications and Calculations

 

Test Bank

 

ESSAY

 

  1. Order: trihexyphenidyl hydrochloride (Artane) 6 mg, PO, twice daily

Available:

How many tablet(s) should the client receive on a daily basis?

 

 

  1. Order: allopurinol (Zyloprim) 150 mg, PO, q.i.d.

Available:

 

  1. How many tablet(s) should be given per dose?
  2. How many mg will the client receive per day?

 

  1. Order: doxycycline hyclate (Vibra-Tabs) 100 mg, PO, first day q12h; then100 mg, PO, daily

Available:

 

  1. How many tablet(s) should the client receive the first day?
  2. How many tablet(s) should the client receive daily after the first day?

 

 

  1. Order: Augmentin 500 mg, PO, q8h

Available:

 

How many tablet(s) should be given per dose?

 

 

  1. Order: erythromycin 350 mg, PO, q8h.

Available: erythromycin estolate 250 mg/5 mL

How many mL should be given per dose?

 

 

  1. Order: Mycostatin U 300,000, PO, q.i.d. (swish and swallow)

Available: Mycostatin 100,000 units per mL

 

How many mL should be given?

 

 

 

 

 

 

 

 

 

  1. Order: Norvir 600 mg, PO, b.i.d.

Available:

 

 

  1. How many milliliters (mL) should the client receive per dose?
  2. How many milligrams (mg) should the client receive per day?

 

: Physiological Integrity: Pharmacological and Parenteral Therapies

 

  1. Order: methenamine mandelate 500 mg, PO, q.i.d.

Available:

 

How many tablet(s) should be given per dose?

 

 

  1. Order: cefadroxil (Duricef) 0.4 g, PO, q12h

Available:

 

How many mL should be given per dose?

 

 

  1. Order: Serzone (nefazodone hydrochloride), PO: Day 1, 200 mg in two divided doses; Day 2, 100 mg in two divided doses; may increase to 100 mg, b.i.d.

Available:

 

 

  1. How many tablets should the client receive on Day 1?
  2. How many tablets should the client receive per dose when ordered 100 mg in 2 divided doses?
  3. How many tablets should the client receive per dose when increased to 100 mg, b.i.d.?

 

 

  1. Order: amoxicillin (Amoxil) 300 mg, PO, q8h

Available:

 

  1. How many mL should the client receive per dose?
  2. How many mg should the client receive per day?
  3. How many mL should the client receive per day?

 

 

  1. Order: Thorazine 10 mg, IM (deep), STAT

Available:

 

How many mL should be given?

 

 

 

  1. Order: Compazine 7.5 mg, IM (deep), q.i.d., PRN

Available:

 

How many mL should be given per dose?

 

  1. Order: loxapine (Loxitane) 75 mg, IM, daily

Available:

 

How many milliliters (mL) should the client receive?

 

 

 

 

  1. Order: midazolam (Versed) 3 mg, IM, STAT

Available: Versed 10 mg/2 mL

How many mL should be given?

 

 

  1. Order: 1000 mL of lactated Ringer’s (LR) solution to be administered in 6 hours

Available: 1 L LR Macrodrip set labeled 10 gtt/mL

  1. How many mL of LR should be infused in 1 hour?
  2. How many drops per minute (gtt/min) should the client receive?

 

 

  1. Order: aminocaproic acid 4 g in 250 mL D5W to infuse in 1 hour

Set: secondary set labeled 15 gtt/min

Available:

 

  1. How many mL of aminocaproic acid should be mixed in 250 mL of D5W?
  2. How many gtt/min should the client receive?

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 6: The Drug Approval Process

 

Test Bank

 

              MULTIPLE CHOICE

 

  1. The term for the universally accepted, official name of a drug is the _____ name.
a. brand
b. trade
c. proprietary
d. generic

 

 

 

  1. What is the current authoritative source for drug standards in the United States?
a. International Pharmacopeia
b. United States Pharmacopeia
c. Food, Drug, and Cosmetic Act
d. Comprehensive Drug Abuse Prevention and Control Act

 

 

 

  1. Each state has laws regarding drug administration by nurses. What is this legislation part of?
a. National League for Nurses
b. American Nurses Association
c. Nurse practice acts
d. Drug standards

 

 

  1. A nurse is administering a cough syrup that contains codeine. The nurse recognizes that the syrup would be classified as which of the controlled substance schedules?
a. I
b. II
c. III
d. V

 

 

 

  1. A client has been prescribed an expensive drug. If available, what drug group may be suggested to decrease drug cost with the healthcare provider’s approval?
a. Generic
b. Trade
c. Brand name
d. Chemical

 

 

 

  1. A nurse is learning safe administration of controlled substances. Which would be the highest priority action on the part of the nurse when administering controlled substances?
a. Maintain special written records for certain categories of controlled substances.
b. Discard wasted controlled substance and countersign with another nurse.
c. Ensure that only the charge nurse carries the narcotic keys.
d. Ensure that drugs on hand and documentation match at least once weekly.

 

 

 

  1. The nurse inadvertently gives the wrong dose of a drug, resulting in the client’s death. This would be classified legally as:
a. misfeasance.
b. nonfeasance.
c. malfeasance.
d. malpractice.

 

 

 

  1. The client is due to receive codeine in combination with acetaminophen. The nurse recognizes that the dosage will be on which controlled substance schedule?
a. II
b. III
c. IV
d. V

 

 

 

  1. The client’s treatment regimen is changed, and he is placed on oxycodone. The nurse recognizes that the drug will be on which controlled substance schedule?
a. II
b. III
c. IV
d. V

 

 

:

 

  1. A client refuses to take a medication. What nursing action is warranted in this case according to the Code of Ethics for nurses?
a. Force the client to take the medication.
b. Contact the physician to get an order for restraints to ensure medication administration.
c. Attempt to convince the client to take the medication.
d. Determine the client’s rationales for refusing the medication.

 

 

 

  1. A nurse working at a nursing home is administering medications. The nurse misreads the medication orders and administers a medication via the intravenous line, rather than via an intramuscular injection. The client sustains permanent injuries and eventually dies. This nurse charged with:
a. misfeasance.
b. nonfeasance.
c. malfeasance.
d. malpractice.

 

 

 

  1. Which is an example of primary prevention in avoiding ingestions and poisoning in children?
a. Provide billboards with poison control center phone numbers.
b. Lavage the stomach to remove poisons from the stomach.
c. Provide antidotes for poisonings specific to the agent.
d. Administer CPR to clients who have ingested poisonous agents.

 

 

 

MULTIPLE RESPONSE

 

  1. A nurse is preparing to administer a Schedule II medication to a client. Which actions are part of this process? (Select all that apply.)
a. Cosign the medication with a physician.
b. Witness any wasted medication with another registered nurse.
c. Access the medication from a single locked cabinet.
d. Ensure that two nurses check the dosage.
e. Ensure that two nurses sign the medication record.
f. Assess the client’s response to the medication.

 

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 7: Cultural and Pharmacogenetic Considerations

 

Test Bank

 

              MULTIPLE CHOICE

 

  1. A nurse conversing with a client is aware that the majority of the message may be nonverbal in some clients from which culture?
a. Asian
b. African American
c. Latino
d. European

 

 

 

  1. The nurse is caring for a client with type 1 diabetes. The nurse is aware that this illness requires scheduled meals, blood glucose monitoring, and medications. Which of the following cultural traits may provide the greatest challenge to health maintenance?
a. Focus on health and well-being
b. Lack of emphasis on time and routine
c. Belief in a higher being
d. Personal philosophy of self-care

 

 

 

  1. The client is being admitted to the hospital for a surgical procedure. He lives with his spouse and 11 children, all of whom are younger than 18 years. What should the nurse recognize may be a major concern for this client?
a. A need for increased verbal communication from the nurse
b. A change in the social organization of his family
c. Insecurity because he is used to a more dense living area
d. Lack of modesty in the semiprivate hospital room

 

 

 

  1. The nurse is caring for a client who is of Filipino descent. He arrived at the hospital with his entire extended family, who indicated that they intended to remain in his room to assist in his care. What should be the highest priority action on the part of the nurse?
a. Call the physician for an order to limit the number of family members allowed in the room.
b. Ask the client to ask his family members to limit themselves to only two in the room.
c. Ask the nurse manager to be present when the nurse explains the situation to the family.
d. Recognize that this is a behavior that may be part of the Filipino culture.

 

 

 

  1. The nurse is caring for a client who is a member of the local Hispanic community. The client asks if she can see her traditional healer while she is hospitalized. What is the most appropriate response from the nurse?
a. “Yes, we can certainly arrange for you to see the healer while you’re here.”
b. “Yes, but only with one of the nurses or your physician present.”
c. “No, I’m afraid that Security wouldn’t allow that to happen.”
d. “No, we can’t include someone like that in your plan of care.”

 

 

 

  1. The nurse is caring for an African-American client who is scheduled to be treated with a beta-blocker medication. The nurse should recognize that this client may:
a. have a hyperactive response to this medication.
b. develop a hypersensitivity reaction to this medication.
c. respond poorly to treatment with this medication.
d. develop multiple side effects in response to this medication.

 

 

 

  1. The nurse is caring for several clients. Which client is most likely to be found to have a low calcium level?
a. 56-year-old Vietnamese man
b. 38-year-old Hispanic woman
c. 25-year-old African-American man
d. 70-year-old Caucasian man

 

 

 

  1. The nurse is caring for a postoperative 35-year-old Asian man. What should the nurse expect the client’s pain level to be?
a. Greater than usual, since he may not respond well to the pain medication
b. Less than usual, since he responds exceptionally well to the pain medication
c. Greater than usual, since he will tend to have a reaction to the pain medication
d. Less than usual, since his stoicism will cause him to require less pain medication

 

 

 

  1. The nurse is caring for a 62-year-old African-American woman who has been placed on Coumadin. The nurse should expect the client’s response to this medication to be:
a. greater than usual; she may respond exceptionally well to the medication.
b. less than usual; she will probably have a decreased therapeutic effect.
c. greater than usual; she should be monitored closely for bleeding irregularities.
d. less than usual; she will tend to experience a hypersensitivity reaction.

 

 

 

 

MULTIPLE RESPONSE

 

  1. A nurse is assessing a client’s cultural background. What is part of this assessment? (Select all that apply.)
a. Communication patterns
b. Orientation to time
c. Organizational skills
d. Social organization
e. Work ethic
f. Biological variations

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 8: Drug Interactions and Over-the-Counter Drugs

 

Test Bank

 

              MULTIPLE CHOICE

 

  1. A nurse is monitoring for drug interactions based on which premise about drug interactions?
a. Drug interactions are undesirable drug effects.
b. Drug interactions are changes occurring with drug absorption.
c. Drug interactions are altered effects of a drug from interaction with other drugs.
d. Drug interactions are reactions that occur in vitro.

 

 

 

  1. The nurse is aware that drugs can block, decrease, or increase the actions of another drug. Laxatives can have which effect on drug absorption?
a. Increase
b. Decrease
c. Block
d. Enhance

 

 

 

  1. Narcotics and anticholinergic drugs (atropine-like drugs) decrease gastrointestinal (GI) motility. Decreasing GI motility has what effect on drug absorption?
a. Increases drug absorption
b. Decreases drug absorption
c. Blocks drug absorption
d. Does not change drug absorption

 

 

 

  1. A client is taking antacids with an antibiotic. The nurse’s instructions are based on the fact that antacids such as aluminum hydroxide (Amphojel) can:
a. increase drug absorption.
b. slow drug metabolism.
c. increase drug metabolism.
d. slow or block drug absorption.

 

 

 

  1. A client is ordered to receive warfarin (Coumadin), which is highly protein bound. Another medication that is equally highly protein bound is ordered. The nurse anticipates that the dosage will be:
a. increased for one drug.
b. increased for both drugs.
c. decreased for one drug.
d. decreased for both drugs.

 

 

 

  1. The nurse has provided instructions to a client taking diazepam (Valium) for short-term anxiety. Which statement by the client indicates that the client needs additional instruction?
a. “I will avoid drinking alcohol while taking this drug.”
b. “I will continue to eat grapefruit while taking this drug.”
c. “I will avoid using heavy equipment when taking this drug.”
d. “I will contact the healthcare provider if I develop a rash.”

 

 

 

  1. Cimetidine (Tagamet) is an enzyme inhibitor for the medication theophylline. Drugs that are enzyme inhibitors:
a. convert drugs to metabolites.
b. increase metabolism, promoting drug elimination.
c. decrease metabolism, promoting an increase in plasma drug concentration.
d. increase drug action.

 

 

 

  1. A client smokes regularly. She takes theophylline (Theo-Dur and others) daily. What is an effect of smoking while on theophylline?
a. Decrease in theophylline clearance
b. Increase in theophylline clearance
c. Increase in the distribution of theophylline
d. Decrease in the dose for theophylline

 

 

 

  1. Some drugs can affect the excretion of other drugs. The antidysrhythmic drug quinidine decreases the excretion of digoxin (Lanoxin). How would the digoxin concentration in the body fluids be affected?
a. No effect
b. Decreased
c. Increased
d. Unabsorbed

 

 

 

  1. A client is receiving two analgesics for pain relief. Two drugs with similar action are administered to achieve which kind of effect?
a. Additive
b. Synergistic
c. Opposing
d. Antagonistic

 

 

 

  1. A client is scheduled for surgery, and an antihistamine and narcotic have been prescribed as preoperative drugs. The antihistamine increases the effect of the narcotic. This is an example of which drug effect?
a. Additive
b. Potentiation
c. Opposing
d. Antagonistic

 

 

 

  1. A client receives morphine sulfate and demonstrates signs of respiratory depression. The physician orders naloxone (Narcan) to block the effects of the narcotic. When two drugs given concurrently have opposite effects, what kind of pharmacodynamic interactions occur?

 

a. Additive
b. Synergistic
c. Agonistic
d. Antagonistic

 

 

 

  1. Food is known to increase, decrease, or delay drug absorption. A client has a high serum cholesterol level, and lovastatin (Mevacor) is prescribed. The client is taking the drug at mealtime and asks why this is necessary. What does taking lovastatin with food accomplish?
a. Decrease in drug absorption
b. Decrease in drug absorption
c. Decrease in drug action
d. Increase in drug excretion

 

 

 

  1. A client is taking tetracycline for acne. It is a drug known to cause photosensitivity. To avoid phototoxicity, the nurse provides client teaching. Which statement by the client indicates a need for more teaching?
a. “I need to avoid excessive sunlight.”
b. “I need to use sunscreen when I go out during the day.”
c. “I need to wear protective clothing over exposed skin areas in sunlight.”
d. “I can stay in the sun for only about 4 hours a day.”

 

 

 

  1. The nurse instructs a client with which condition to avoid taking over-the-counter cough and cold remedies?
a. High blood cholesterol
b. Rheumatoid arthritis
c. Hypotension
d. Thyroid disease

 

 

 

  1. Some medications previously requiring a prescription are now available as over-the-counter (OTC) drugs. Client teaching related to OTC drugs should include:
a. instructions to take only prescribed drugs.
b. instructions to report OTC drugs being taken to the healthcare provider.
c. teaching that herbal drugs can be taken with prescribed drugs.
d. teaching that all OTC drugs are considered safe.

 

 

 

  1. A client with a history of deep vein thrombosis takes warfarin (Coumadin) daily. He has been experiencing headaches and has been taking over-the-counter pain relievers. The nurse discovers that the client is taking aspirin. Which assessment should the nurse be most attentive to at this time?
a. The client reports that his gums are bleeding more than usual when he brushes his teeth.
b. The client complains of constipation.
c. The client reports that he is unable to sleep at night despite feeling very fatigued.
d. The nurse notes that the client has a runny nose and some nasal congestion.

 

 

 

  1. A client eats a large meal and then takes her medications. Usually food has which effect on drug dissolution and absorption?
a. Enhances
b. Increases
c. Decreases
d. No effect

 

 

 

  1. The nurse is caring for a client who is being treated with aspirin and an oral antidiabetic agent. The nurse anticipates an increased risk of _____ from the interaction between the drugs.
a. bleeding
b. clotting
c. hypoglycemia
d. hyperglycemia

 

 

 

  1. The nurse is caring for a client who is being treated with both isoniazid and phenytoin. The nurse anticipates which result from the interaction between the drugs?
a. Toxic level of phenytoin
b. Subnormal level of isoniazid
c. Toxic level of isoniazid
d. Subnormal level of phenytoin

 

 

 

  1. The nurse notes that the client has been ordered to receive both aminophylline and dobutamine by IV infusion. The client has one IV access and has been dehydrated. What is the highest priority action on the part of the nurse?
a. Call the pharmacist for additional information on the medications.
b. Start a second intravenous access in the client’s arm.
c. Call the physician for orders regarding the medications.
d. Administer the medications using piggyback tubing.

 

 

 

MULTIPLE RESPONSE

 

  1. Which drug groups are considered to be over-the-counter (OTC) drug groups? (Select all that apply.)
a. Herbal products
b. Laxatives
c. Antibiotics
d. Antacids

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 9: Drugs of Abuse

 

Test Bank

 

              MULTIPLE CHOICE

 

  1. The nurse instructs a client prescribed alprazolam (Xanax) for treatment of short-term anxiety to avoid which herbal preparation?
a. Chamomile
b. Ginger
c. Saw palmetto
d. Valerian

 

 

 

 

  1. A client is admitted to the emergency room after overdosing on a benzodiazepine. The nurse anticipates that the healthcare provider will order which antidote?
a. Caffeine
b. Epinephrine (Adrenalin)
c. Flumazenil (Romazicon)
d. Phentolamine (Regitine)

 

 

 

 

  1. A client has terminal cancer. She is taking large doses of opiates to control pain. The nurse should:
a. inform the client to decrease drug dose to avoid drug addiction.
b. instruct the client to increase drug dose.
c. discontinue the client’s opiates to avoid drug addiction.
d. allow the prescribed opiate dose unless drug toxicity occurs.

 

 

  1. A client enters the emergency department complaining of acute lower right quadrant abdominal pain. It is determined that the client has appendicitis and is scheduled to go to the operating room immediately. The nurse notes on the database that the client generally drinks 10 to 12 beers a day, although he did not drink in the past 4 days because of the pain. The nurse would expect that the:
a. client’s surgery would be canceled because of the threat of a withdrawal reaction.
b. client’s surgery would proceed with no change in the plan of care.
c. client would require a greater level of anesthesia as a result of cross-tolerance.
d. client would need less anesthesia because of the circulating blood alcohol.

 

 

 

 

  1. The spouse of a client asks why her husband seems to drink more when he is depressed. What should the nurse say in response?
a. “The body craves alcohol more when someone is sad.”
b. “A person’s mood does not have any impact on his or her drinking.”
c. “Depression is an excuse to drink.”
d. “Research indicates that alcohol elevates a person’s mood.”

 

 

 

 

  1. A client expresses the desire to quit smoking. She elects to use Nicorette gum replacement therapy. Which statement by the nurse is true regarding this smoking cessation technique?
a. “You should not eat or drink for 15 minutes before or after chewing the gum.”
b. “You may experience a skin rash as a result of this treatment.”
c. “Using a nicotine replacement system will decrease the risk of cancer.”
d. “The gum will take away the craving to smoke.”

 

 

  1. A client with a history of long-term alcohol abuse is diagnosed with Wernicke’s encephalopathy. The nurse would plan the client’s care with the knowledge that which treatment will be needed first?
a. Large volumes of intravenous fluids to rehydrate
b. Bolus of high-concentration glucose solution to treat hypoglycemia
c. Intravenous thiamine to address nutritional deficiency
d. Administration of stimulants to counteract depression

 

 

 

  1. A client is admitted to a nursing unit in acute alcoholic withdrawal. Which nursing diagnosis is the highest priority early in this admission?
a. Risk for injury related to disorientation and seizure activity
b. Disturbed thought processes due to symptoms of withdrawal
c. Imbalanced nutrition: less than body requirements due to poor intake
d. Acute constipation related to effects of poor nutrition and decreased activity

 

 

 

 

  1. A nurse in the emergency department receives a call that a client is being transported to the hospital by paramedics. The client is a known heroin addict and is showing signs of potential overdose. The nurse would expect which symptoms?
a. Anxiety, blurred vision, agitation
b. Clammy skin, constricted pupils, decreased level of consciousness
c. Fatigue, paranoia, hallucinations
d. Panic behaviors, tachycardia, hypertension

 

 

 

 

  1. A postoperative client received morphine in the recovery room. On assessment, the nurse notes that the client’s respiratory rate is 6 breaths per minute and that the client has a decreased level of consciousness. The anesthesiologist orders naloxone (Narcan). The nurse administers this medication with the knowledge that this drug is a(n):
a. respiratory stimulant.
b. opioid antagonist.
c. bronchodilator.
d. anticonvulsant.

 

 

 

 

  1. A client with congestive heart failure receives digoxin (Lanoxin) to slow and strengthen ventricular contraction. He tells a nurse during his health history that he frequently uses amphetamines to “deal with all the stress.” Which assessments and diagnostics would be a priority for this client?
a. Urinalysis and creatinine clearance
b. Digoxin levels and palpation for edema
c. Blood pressure and BUN
d. Auscultation of heart rhythm and an ECG

 

 

 

 

  1. Which client statement demonstrates the greatest readiness for smoking or alcohol cessation?
a. “I will cut down my smoking and drinking, but I won’t stop completely.”
b. “I don’t know why everyone thinks my smoking and drinking are a problem.”
c. “I need help in dealing with my addiction to smoking and drinking.”
d. “I will quit when my smoking and drinking really affect my life.”

 

 

  1. The nurse is caring for a client with opioid addiction. The client requires the reversal of respiratory depression and coma. The nurse anticipates that she will be treated with which medication?
a. Methadone (Dolophine)
b. Buprenorphine (Subutex)
c. Naltrexone (ReVia, Depade)
d. Naloxone (Narcan)

 

 

 

 

  1. The nurse is caring for a client who is detoxifying after an opioid overdose. The nurse anticipates that which drug will be given to substitute for the opioid?
a. Nalmefene (Revex)
b. Naltrexone (ReVia, Depade)
c. Phenytoin (Dilantin)
d. Buprenorphine (Subutex)

 

 

 

 

  1. The client is receiving nicotine replacement therapy in the form of the Commit lozenge. The client tells the nurse that she has been experiencing extreme nausea and indigestion. The nurse recognizes that the client is probably making which mistake?
a. Taking too many of the lozenges per day
b. Letting the lozenge dissolve over a long time period
c. Chewing and swallowing the lozenge
d. Taking too few of the lozenges per day

 

 

 

 

MULTIPLE RESPONSE

 

  1. The nurse is aware that some drugs of abuse may cause significant withdrawal effects. The nurse anticipates withdrawal syndromes with which medications? (Select all that apply.)
a. Cannabinoids
b. Opioids
c. Alcohol
d. Amphetamines
e. Barbiturates
f. Anxiolytics

 

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 10: Herbal Therapy with Nursing Implications

 

Test Bank

 

MULTIPLE CHOICE

 

  1. Appropriate labeling on an herbal product may include which information?
a. Batch and lot numbers
b. “May cure multiple sclerosis”
c. “Helps prevent heart disease”
d. “May substitute for prescription cardiac medication”

 

 

 

  1. Which herbal preparation is a client most likely to select as a laxative?
a. Lemon balm
b. Capsicum
c. Hops
d. Aloe vera

 

 

 

  1. Which statement is true about saw palmetto?
a. It acts as an astringent.
b. It has antiandrogenic properties.
c. It is used as a flavoring agent.
d. It decreases cholesterol levels.

 

 

 

  1. Isolating components of an herb leads to more reliable dosing and results in which form?
a. Dried herb
b. Extract
c. Syrup
d. Oil

 

 

 

  1. A nurse is instructing a client about safe use of herbal supplements. Which client could use herbal therapy most safely?
a. 5-year-old boy
b. 25-year-old pregnant woman
c. 72-year-old man
d. 42-year-old woman

 

 

 

  1. Which herb may lower seizure threshold if taken with anticonvulsants?
a. Evening primrose
b. Milk thistle
c. Saw palmetto
d. Ginkgo biloba

 

 

 

  1. Which herb may be used to treat liver disease?
a. Milk thistle
b. Echinacea
c. St. John’s wort
d. Saw palmetto

 

 

 

  1. The effects of St. John’s wort are expected to manifest in:
a. 1 week to 10 days.
b. 2 to 3 weeks.
c. 4 to 8 weeks.
d. 12 to 6 weeks.

 

 

 

  1. A client enters the nurse practitioner’s office complaining of menstrual cramps and an irregular menstrual cycle. The client states that she has been taking an herb that has been used to address these symptoms. Which herb may she be referring to?
a. Ginger
b. Ginkgo biloba
c. Echinacea
d. Dong quai

 

 

 

 

 

  1. Which herb is frequently used to treat digestive disorders?
a. Milk thistle
b. Peppermint
c. Valerian
d. Goldenseal

 

 

  1. A client is receiving chemotherapy to treat a solid organ tumor. The client admits to the nurse that he has been drinking Chinese teas to treat the disease. What is the appropriate response from the nurse?
a. “You have the right to use any nonmedicinal treatments you want.”
b. “You should not take any alternative medications while on chemotherapy.”
c. “We must be sure that your teas do not interact with the chemotherapy.”
d. “Traditional medicines and herbal therapy should not be used together.”

 

 

 

  1. The client who is self-medicating with cayenne and also being treated with _____ is most likely to experience a drug interaction.
a. theophylline
b. warfarin
c. tetracycline
d. Vibramycin

 

 

 

 

 

  1. The client who is self-medicating with psyllium and also being treated with _____ is most likely to experience a drug interaction.
a. Valium
b. Prozac
c. lithium
d. Ativan

 

 

 

  1. The client is being treated for hypertension. He tells the nurse that he has been taking Yohimbe. The nurse anticipates a(n) _____ drug effect and _____ hypertension as a result of this self-medication.
a. decreased; decreased
b. decreased; increased
c. increased; decreased
d. increased; increased

 

 

 

MULTIPLE RESPONSE

 

  1. Which herbs are thought to decrease platelet aggregation? (Select all that apply.)
a. Garlic
b. Goldenseal
c. Ginger
d. Ginkgo biloba
e. Feverfew
f. Ginseng

 

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 11: Pediatric Pharmacology

 

Test Bank

 

MULTIPLE CHOICE

 

  1. Neonates and infants have a decreased metabolism and excretion of drugs because of immaturity of which organs?
a. Lungs and kidneys
b. Liver and kidneys
c. Spleen and pancreas
d. Gastrointestinal tract and kidneys

 

 

 

  1. The gastric pH of children younger than 3 years is more alkaline than that of adults. Penicillin can be destroyed by gastric acidity. The penicillin dose for a child younger than 3 years compared to that for an adult should be:
a. the same.
b. higher.
c. lower.
d. doubled.

 

 

 

  1. Infants have decreased plasma protein-binding sites because of decreased plasma protein and albumin levels. With drugs that are highly protein bound, how should the drug dose for infants be different from that for adults?
a. It should be higher.
b. It should be lower.
c. It should be the same.
d. It varies by client.

 

 

 

  1. Drug half-life for an older child can be shortened because of increased metabolic rate. How does this affect the drug dose for older children versus that for adults?
a. It is increased because of drug metabolism.
b. It is decreased because of drug metabolism.
c. It is decreased because of an increased half-life.
d. It is the same as that for adults.

 

 

 

  1. The nurse understands that the drug distribution in an infant is affected by which factor?
a. Infants have fewer protein receptor sites.
b. Albumin levels are increased in infants.
c. Infants have lower levels of extracellular fluids.
d. Body fluid proportion for weight is decreased in infants.

 

 

 

  1. What does teaching to clients with children include?
a. Advising the client and family to keep medications in readily available, convenient locations
b. Instructing the client and family not to be concerned with side effects of medications
c. Telling the client and family to purchase over-the-counter drugs to reduce costs
d. Instructing the client and family to use child-resistant medication containers

 

 

e

 

  1. The _____ route is the most exact and predictable route through which to administer medications to children.
a. oral
b. rectal
c. intramuscular
d. intravenous

 

 

 

  1. The nurse develops a medication teaching plan for an adolescent client. Which principle will be highest priority to include when teaching the adolescent client?
a. Emotional development occurs at the same time for all adolescents.
b. All information shared with the nurse will remain confidential.
c. The client can be assured of appropriate levels of privacy.
d. Adolescents do not need assistance with decision making about medications.

 

 

 

 

  1. The nurse prepares to administer a crushed medication to an 11-month-old child. Which food or beverage will the nurse mix with the medication to make it more palatable?
a. Ginger ale
b. Honey
c. Jelly
d. Milk

 

 

 

  1. An infant client is ordered to receive a topical silver nitrate ointment to prevent infection after sustaining burns. The nurse be especially vigilant for signs of silver toxicity because:
a. infants have immature liver function and metabolism.
b. infants have decreased renal function and renal clearance.
c. infants’ bodies have increased body water composition.
d. infants have thinner skin, allowing for greater absorption.

 

 

 

  1. In terms of calculation of drug dosages, which information will be most important for the nurse to collect regarding a pediatric client upon his or her first clinic visit?
a. Health status, nutritional status, and hydration status
b. Age, weight, and height
c. Current use of prescription, over-the-counter, and herbal medications
d. Allergy history of the child and family allergy history

 

 

 

  1. The nurse is caring for a pediatric client who has a long-term, chronic illness. The nurse notes that the client needed an increase in his medication dosage once he reached age 14 years. The nurse is aware that this is most likely due to:
a. hormonal changes and growth spurts.
b. decrease in the metabolic rate.
c. decrease in sleep requirements.
d. slowing of physical maturation.

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 12: Geriatric Pharmacology

 

Test Bank

 

MULTIPLE CHOICE

 

  1. The nurse plans to closely monitor an older adult client who is receiving multiple drugs for evidence of adequate excretion of the medications. Which two major organs affecting drug clearance from the body should be monitored when an older adult client is receiving multiple drugs?
a. Kidneys and lungs
b. Kidneys and pancreas
c. Liver and pancreas
d. Liver and kidneys

 

 

 

  1. The nurse is aware that increased _____ may affect the absorption of medications.
a. gastric motility
b. alkaline gastric secretion
c. intestinal emptying time
d. peristalsis

 

 

 

 

  1. The older adult client is prescribed a drug that is excreted through the urine. The nurse anticipates that which laboratory test will be prescribed to evaluate renal function before administration of the medication?
a. Blood urea nitrogen
b. Serum albumin
c. Serum electrolytes
d. White blood cell count

 

 

 

  1. The nurse recognizes that polypharmacy is more likely to occur in an older adult client because the older client:
a. has difficulty maintaining a list of current medications.
b. experiences changes in visual capability.
c. experiences alterations in mental capacity.
d. may obtain prescribed drugs from various providers.

 

 

 

 

  1. The diuretic hydrochlorothiazide (HCTZ; HydroDIURIL) is usually prescribed for the older adult in a lower dose. The nurse recognizes that this is an attempt to prevent the older adult from experiencing a(n):
a. increase in potassium loss.
b. decrease in sodium loss.
c. decrease in blood sugar levels.
d. increase in red and white blood cell count.

 

 

 

  1. The nurse notes that Cimetidine has been prescribed for an older adult client. The nurse’s highest priority would be to call:
a. the physician.
b. the pharmacist.
c. the nursing supervisor.
d. Poison Control.

 

 

 

 

  1. An older adult client says that he has difficulty removing the cap from his medication bottle. He says, “That’s why I don’t always take my medication.” The nurse should suggest that he:
a. ask a neighbor to help him remove the bottle cap.
b. ask the pharmacist to put the drug in a non–childproof container.
c. have a family member visit daily to prepare his medications.
d. ask the healthcare provider not to prescribe drugs that come in childproof bottles.

 

 

 

 

  1. A client is demonstrating signs and symptoms of disorientation. Which question by the nurse would be appropriate, related to the client’s medication use?
a. “Are you taking any new medications?”
b. “Do you take medications with a full glass of water?”
c. “Do your medications make you constipated?”
d. “Have you been diagnosed with dementia?”

 

 

 

 

  1. The nurse is caring for an older adult client and a middle-aged adult client. The nurse anticipates that the medication doses for the older adult will be _____ those for the middle-aged adult.
a. the same as
b. less than
c. slightly more than
d. twice as much as

 

 

 

  1. An older adult client is ordered to receive digoxin (Lanoxin). The client has decreased renal function. Which condition could indicate digoxin toxicity?
a. Elevated blood pressure
b. Decreased blood pressure
c. Heart rate greater than 100 beats per minute
d. Heart rate less than 60 beats per minute

 

 

 

  1. A client takes ibuprofen to deal with the pain of arthritis. The client complains of gastrointestinal symptoms. Which is an appropriate strategy for the nurse to teach the client?
a. “Take the medication on an empty stomach.”
b. “Do not take the medication if it has side effects.”
c. “Try to take an antacid 1 hour before the dose.”
d. “You must take the medication anyway.”

 

 

 

  1. A nurse is administering medication to an older adult client. The nurse is aware that the client’s half-life is longer than that of middle-aged adults. What nursing intervention is indicated by this premise?
a. Provide higher doses to achieve therapeutic effects.
b. Assess the client for adverse reactions.
c. Monitor the client for signs of accumulation.
d. Provide education to the client on drug reactions.

 

 

 

  1. The nurse is caring for an older adult client who complains that she has to take multiple medications at various times throughout the day. What is the most appropriate nursing intervention for the nurse to implement with this client?
a. Encourage family members or friends to monitor drug regimen.
b. Explain the purpose, drug action, and importance of medication.
c. Develop a chart indicating times to take drugs.
d. Provide time for questions; reinforce with written information.

 

 

 

  1. The physician is recommending a benzodiazepine medication for an older adult client who has previously been treated with Valium. The nurse recognizes that which medication would be most appropriate for this client?
a. Librium
b. Dalmane
c. Ativan
d. Equanil

 

 

 

  1. Which older adult client is most likely to experience digoxin toxicity?
a. 72-year-old man who is also experiencing hyperkalemia
b. 74-year-old woman who is also experiencing hypokalemia
c. 66-year-old woman who is also experiencing hypercalcemia
d. 62-year-old woman who is also experiencing hypocalcemia

 

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 13: Medication Administration in Community Settings

 

Test Bank

 

MULTIPLE CHOICE

 

  1. A community health nurse is teaching a client about a new medication. The nurse is aware that it is important to advise clients and families that the therapeutic response from psychotropic drugs may not occur until after:
a. 24 to 72 hours.
b. 1 week.
c. 2 weeks.
d. 6 weeks.

 

 

 

  1. The nurse is teaching the client about cautions when using over-the-counter medications while the client is taking prescription medications. What is the issue of concern?
a. Drug-lab interactions
b. Drug-drug interactions
c. Drug-food interactions
d. Adverse medication effects

 

 

 

  1. A nurse working in a school administers medications to many children at lunch. One day, a child states that she “feels funny” after being given a medication and that “she has never felt this way before.” What is the correct initial action for the nurse to take?
a. Tell the child to lie down.
b. Call the child’s parent or guardian.
c. Assess the child.
d. Send the child back to class.

 

 

 

 

  1. A client who works on a factory assembly line takes a medication with the side effect of drowsiness. She works the 11:00 PM to 7:00 AM shift. The occupational health nurse would recommend that the client take the medication at:
a. 6:00 AM so it peaks after she leaves work.
b. 8:00 AM when she is home from work.
c. 5:00 PM with her large meal of the day.
d. 10:00 PM to maintain a normal schedule.

 

 

 

 

  1. An Asian client enters a community health setting. Based on cultural norms, the nurse might anticipate that the client will:
a. be very verbal and demonstrative about symptoms.
b. have an increased risk for having poor nutrition.
c. be noncompliant with the plan of care.
d. have attempted self-diagnosis and self-treatment.

 

 

 

  1. A nurse working in a home is responsible for providing medications to a client. What is true about this procedure?
a. The nurse can give medications only under the direct supervision of a healthcare provider.
b. The nurse may give any medication as requested by the client.
c. The nurse is unable to administer medications in the home.
d. The nurse can give medications only as ordered by a healthcare provider.

 

 

 

 

  1. A client asks a home health aide, called an unlicensed assistive personnel (UAP), to provide medications. Under what conditions can this occur?
a. If the UAP is a nursing student and has taken a pharmacology course
b. If the UAP helps the client to take medication he or she usually self-administers
c. Whenever the client requests a medication
d. Under no circumstances can a UAP give medications in the home

 

 

 

  1. A child brings unlabeled medications in a plastic bag to the school nurse. What should the nurse do?
a. Call the parent or guardian for the labeled pharmacy bottle.
b. Administer the medication that day and send a note home.
c. Administer the medication if the child can identify the medication
d. Allow the student to take his or her own medication.

 

 

 

  1. An occupational health nurse works in a setting with standardized medication protocols. The protocol that should be questioned by the professional nurse is administering:
a. ibuprofen for menstrual cramps.
b. antacids for gastric upset.
c. penicillin for signs of infection.
d. acetaminophen for a fever.

 

 

 

  1. The nurse recognizes that a(n) _____ client is most likely to need food rituals as part of the medication regimen in the home setting.
a. Amish
b. Egyptian
c. Hispanic
d. Appalachian

 

 

 

  1. The _____ client is most likely to feel a religious obligation to attempt to care for himself or herself before seeking assistance from an outside source is which client.
a. Hispanic
b. Amish
c. Jewish
d. Muslim

 

 

 

  1. The nurse administers a narcotic to a client who is still complaining of severe pain 15 minutes after administration of the drug. What is the most appropriate response from the nurse?
a. “You should be feeling relief in just a few minutes.”
b. “I’ll call the doctor to see if I can give you some more.”
c. “You’re going to have to tough it out until your next dose.”
d. “I’ll call the pharmacist to see what he says about it.”

 

 

 

  1. A client is to be discharged to home after a motor vehicle crash. He is ordered to receive 200 mg of phenobarbital (Luminal) bid for posttraumatic seizures. The drug label states a medication concentration of 20 mg/4 mL. How many mL should be administered to equal the ordered dosage?
a. 20 mL
b. 400 mL
c. 4 mL
d. 40 mL

 

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 14: The Role of the Nurse in Drug Research

 

Test Bank

 

MULTIPLE CHOICE

 

  1. A nurse is asked to provide a placebo to a client who is in pain. Which nursing action is appropriate?
a. Administer the medication, not disclosing its nature.
b. Administer the medication, disclosing to the client that the drug is a placebo.
c. Administer the placebo with another analgesic.
d. Refuse to administer the placebo.

 

 

 

  1. A nurse researcher is designing an experiment. The nurse is aware that participants in the experimental group serve what function?
a. They receive a placebo.
b. They receive the treatment.
c. They provide a baseline for data measurement.
d. None of the above are true.

 

 

 

  1. Clinical experimentation occurs in four stages. The determination of the human dosage range based on responses in healthy subjects is a goal of phase _____ of human clinical experimentation.
a. I
b. II
c. III
d. IV

 

 

 

  1. A powerful tool in which neither subject or healthcare provider knows to which group the individual is assigned is known as a(n) _____ study.
a. double-blind
b. open-label
c. crossover
d. single-blind

 

 

  1. A nurse is assisting in drug trials that have reached the stage in which potential new indications for approved drugs are investigated. The nurse is aware that this phase is known as phase:
a. I.
b. II.
c. III.
d. IV.

 

 

 

 

  1. A study design in which it is difficult to control variables that may influence results is called a(n) _____ design.

 

a. descriptive
b. quasi-experimental
c. experimental
d. retrospective

 

 

 

  1. According to the FDA Modernization Act of 1997, which statement is true regarding drug experimentation with children?
a. Medications tested on adults are safe for children.
b. Medications should not be tested on children.
c. Medications intended for children require research with children as subjects.
d. Children cannot be participants in drug evaluation studies.

 

 

 

  1. To generalize results from drug studies to a larger population, the nurse researcher employs which strategy?
a. Pure experimentation
b. Placebo treatment
c. Open-label study
d. Probability sampling

 

 

 

  1. The role of the nurse in clinical drug trials is best described as:
a. obtaining informed consent from subjects.
b. explaining all aspects of the study to subjects.
c. ensuring the protection of the subjects’ rights.
d. answering all client questions related to the study.

 

 

  1. A nurse designs a study that investigates the effectiveness of a medication in treating menstrual cramps. Which would best represent the inclusion criteria for this study?
a. Adolescent females
b. Women of childbearing age
c. Women of African-American race
d. Women of any age

 

 

 

  1. A client tells a nurse that she wishes to withdraw from a research study. The nurse will:
a. allow the client to withdraw.
b. encourage the client to stay in the study.
c. inform the client that withdrawing is discouraged.
d. reinforce to the client that alternative treatments are substandard.

 

 

 

  1. Which characteristic of a research study represents a threat to veracity?
a. Deceiving a client as to the nature of the study
b. Providing a treatment to one client that is not provided to another
c. Not allowing the client to receive informed consent to a study
d. Allowing a client to participate in a study without knowledge of the risks

 

 

 

  1. A nurse is participating in clinical trials for a medication. The nurse is told that this study is known as a phase IV trial. A patient asks the nurse what a phase IV trial entails, and the nurse responds that it is testing a medication for:
a. identification of the pharmacokinetics of the drug.
b. safety of the drug for clients who have the disease it treats.
c. human dosage range based on the response from healthy human subjects.
d. safety of the drug for a wide client population.

 

 

 

  1. The nurse is assisting with a research project and is told that only the research subjects themselves are unaware of the groups to which they are assigned. The nurse recognizes that this study will be designed as a(n) _____ study.
a. open-label
b. triple-blind
c. single-blind
d. double-blind

 

 

  1. The nurse who is assisting with a research project is told that each research subject will be used in several different situations. This indicates to the nurse that the research design that is most likely to be used is a _____ design.
a. matched pair
b. crossover
c. double-blind
d. quasi-experimental

 

 

 

  1. Which criterion would be most likely to eliminate a client from providing informed consent?
a. Client cannot state the correct ratio of benefits to risks of the drug.
b. Client states the compensation that will occur if injury results.
c. Client can state the name and only a partial phone number for the contact person.
d. Client writes consent clearly and understands at the eighth-grade reading level.

 

 

 

OTHER

 

  1. The following steps represent the basic sequence of new drug development. Place the steps in correct chronological order.
  2. Preclinical testing
  3. Phase III and phase IV human clinical experiments
  4. Phase II human clinical experiments
  5. Study design of human clinical experiments
  6. Phase I human clinical experiments
  7. Identify potential chemical for medication

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 15: Vitamin and Mineral Replacement

 

Test Bank

 

MULTIPLE CHOICE

 

  1. A client is taking in a larger quantity of a vitamin than is needed by the body. Which vitamin can the nurse expect to see in laboratory results as having been excreted in the client’s urine?
a. A
b. D
c. C
d. E

 

 

 

  1. The client tells that nurse that he is taking large amounts of a variety of vitamins. The highest priority action on the part of the nurse is to caution the client that vitamins _______ can be toxic if taken in excess over time.
a. A and B
b. A and E
c. B and C
d. C and D

 

 

 

  1. A client reports taking megadoses of vitamin D. The nurse instructs the client to be aware of which symptom of vitamin D toxicity?
a. Bradycardia
b. Blurred vision
c. Nausea and vomiting
d. Palpitations

 

 

 

  1. The nurse is teaching the client to increase her intake of foods rich in vitamin B. The client states that she enjoys baked goods frequently. The highest priority action on the part of the nurse is to instruct the client to:
a. consume whole-grain cereal and bread.
b. add more meat to her diet.
c. eat more protein in the form of eggs and cheese.
d. consume more fresh fruit.

 

 

 

  1. The client asks the nurse why she should be taking folic acid while she is pregnant. The best response from the nurse is that folic acid deficiency in the first trimester of pregnancy:
a. can affect the brain development.
b. may cause spinal cord dysfunctions.
c. may cause cardiac anomalies.
d. can cause gastrointestinal abnormalities.

 

 

 

  1. A client is taking doses of vitamin C. She tells the nurse that she has heard that vitamin C prevents and cures colds and that she is wondering if this is true. What is the nurse’s response?
a. “Vitamin C is most helpful in preventing colds, but large doses are required.”
b. “Vitamin C is a fat-soluble vitamin and should not be taken in large doses.”
c. “I have also heard that vitamin C will help prevent colds, but it hasn’t been proven.”
d. “Vitamin C supplements should be taken only by children and older persons.”

 

 

 

  1. The nurse instructs a client taking iron for treatment of iron deficiency anemia to avoid which herbal preparation?
a. Garlic
b. Ginger
c. Milk thistle
d. Peppermint

 

 

 

  1. A client who is being treated with iron supplements is not exhibiting the increased amount in his blood that was anticipated. The nurse suspects that his diet or lifestyle may be inhibiting absorption of the iron. The nurse recognizes that the client’s absorption of iron intake may be hampered by consumption of:
a. oral ascorbic acid and citrus fruits.
b. antacids taken with meals.
c. other multivitamins, ingested concurrently.
d. a full meal 2 hours after iron intake.

 

 

  1. Iron toxicity is a serious cause of poisoning in children. Client teaching includes which instruction?
a. “Recognize that iron tablets resemble candy.”
b. “Keep liquid-type iron preparations in refrigerator.”
c. “Give milk if numerous iron tablets have been ingested.”
d. “It will take 48 hours for the toxic effects of iron overdose to emerge.”

 

 

CATEGORY: Physiological Integrity: Basic Care and Comfort: Nutrition

 

  1. In the past few years, the use of zinc has greatly increased. A client is considering taking a zinc preparation. Based on current knowledge, which statement made by the client indicates a need for more teaching?
a. “Large doses of zinc may decrease the ‘good’ cholesterol.”
b. “Zinc may be taken with all drugs, including antibiotics.”
c. “Zinc is thought by some to alleviate the common cold.”
d. “Large doses of zinc may cause copper deficiency.”

 

 

 

  1. In teaching a client about zinc, the nurse instructs that foods rich in zinc include:
a. meat and eggs.
b. fruits.
c. cheese.
d. milk.

 

 

 

  1. A client is diagnosed with type 2 diabetes mellitus. The nurse counsels the client that which mineral is helpful for controlling non–insulin-dependent diabetes mellitus?
a. Chromium
b. Zinc
c. Iron
d. Selenium

 

 

 

  1. Which mineral is an antioxidant and is thought to reduce the risk of cancer?
a. Iron
b. Chromium
c. Selenium
d. Mercury

 

 

 

  1. A client is ordered to take iron to treat iron deficiency anemia. Which signs and symptoms would the nurse use to evaluate that this treatment was effective?
a. Light brown stools
b. Pallor in the skin
c. Decrease in shortness of breath
d. Persistent fatigue

 

 

 

  1. A nurse is counseling a client taking iron. Which statement is true regarding increasing iron’s absorption in the body?
a. “Take the iron with orange juice.”
b. “Take the iron during a meal.”
c. “Take the iron one half hour after an antacid.”
d. “Swallow the iron pill with a full glass of milk.”

 

 

 

  1. A client is asking a nurse about the need for vitamin therapy. The nurse directs the client that vitamin therapy is most likely to be indicated for those clients who
a. do not suffer from debilitating illness.
b. have an adequate dietary intake.
c. are on a restricted diet.
d. are experiencing a slow growth period.

 

 

 

  1. The client is scheduled to be treated with iron supplements in the form of an elixir. The highest priority instruction that the nurse can provide to the client is that a side effect of this form of the medication can be:
a. persistent headache.
b. staining of the teeth.
c. neck pain.
d. gum deterioration.

 

 

  1. The nurse is caring for a client with sickle cell disease who tells the nurse that she is considering taking large doses of vitamin C because she has read about its ability to enhance wound healing. What is the best response from the nurse?
a. “That should be a very effective way to self-manage your disease process.”
b. “That is contraindicated because of the type of pain medication that you require.”
c. “That should encourage wound healing as well as enhance pain management.”
d. “That is contraindicated because it can lead to sickle cell crisis.”

 

 

 

  1. The client is experiencing iron deficiency anemia and tells the nurse that he has been taking St. John’s wort because it helps stabilize his depression. What is the best response from the nurse?
a. “Don’t take St. John’s wort; it interferes with absorption of your iron tablets.”
b. “That’s a good idea; St. John’s wort will help absorb the iron tablets.”
c. “Don’t take St. John’s wort; it can cause the iron to reach a toxic level.”
d. “That’s a good idea; St. John’s wort will prevent the iron from reaching toxicity.”

 

 

 

  1. The client has been ordered to take iron supplements and is also being treated with antacids. The highest priority action on the part of the nurse is to instruct the client to take the iron supplement:
a. 30 minutes before taking his antacid.
b. within 1 hour of taking the antacid.
c. 1 hour after taking the antacid.
d. 1 hour before the antacid along with milk.

 

 

 

MULTIPLE RESPONSE

 

  1. The nurse should be aware of those vitamins that are fat soluble and those that are water soluble. Which vitamins are fat soluble? (Select all that apply.)
a. A
b. B
c. C
d. D
e. E
f. K

 

 

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 16: Fluid and Electrolyte Replacement

 

Test Bank

 

MULTIPLE CHOICE

 

  1. A client’s serum osmolality is 270 mOsm/kg. What is the client’s body fluid osmolality?
a. Iso-osmolar
b. Hypo-osmolar
c. Hyperosmolar
d. Normosmolar

 

 

 

  1. A client’s serum chemistry values are serum sodium level 142 mEq/L, blood urea nitrogen (BUN) 15 mg/dl, and glucose level 90 mg/dl. What is the client’s body fluid osmolality?
a. Iso-osmolar
b. Hypo-osmolar
c. Hyperosmolar
d. Hypotonic

 

 

 

 

  1. A client’s serum chemistry measurements are serum sodium level 146 mEq/L, BUN 24 mg/dl, and glucose level 90 mg/dl. What is the client’s serum osmolality?
a. 275 mOsm/kg
b. 285 mOsm/kg
c. 295 mOsm/kg
d. 305 mOsm/kg

 

 

 

  1. A client received 3 L of D5W. With continuous use of 5% dextrose in water, the intravenous (IV) fluids become:
a. isotonic.
b. hypotonic.
c. hypertonic.
d. megatonic.

 

 

 

  1. A client is ordered to receive lactated Ringer’s solution. What type of intravenous (IV) solution is this?
a. Lipid
b. Crystalloid
c. Colloid
d. Blood product

 

 

 

  1. A client in severe shock is ordered to receive dextran as a volume expander. This type of fluid known as a:
a. lipid.
b. crystalloid.
c. colloid.
d. blood product.

 

 

 

  1. A nurse is calculating a client’s daily fluid needs. The client weighs 85 kg. The approximate daily fluid requirement is _____ mL.
a. 1700
b. 2000
c. 2550
d. 3000

 

 

 

  1. A client is admitted to the emergency department with tachycardia, hypotension, and a serum sodium level of 115 mEq/L. What does the client’s serum sodium level indicate?
a. Normal serum sodium value
b. Hyponatremia
c. Hypernatremia
d. Hypocalcemia

 

 

 

  1. Which physician order would the nurse question when administering IV fluids with potassium chloride (KCl)?
a. Inject IV KCl directly into the IV tubing.
b. Check for infiltration because potassium is irritating to subcutaneous tissues.
c. Check for phlebitis because potassium is irritating to the veins.
d. Check for adequate urinary output (kidney dysfunction can cause potassium retention that may lead to hyperkalemia).

 

 

 

  1. A client is ordered to receive potassium. The nurse should instruct the client to take KCl at what time of day?
a. Throughout the day with sips of water
b. Before breakfast
c. At bedtime with 1 ounce of fluid
d. At mealtime

 

 

 

  1. A client is instructed to use potassium supplements because a medication that has been prescribed may cause hypokalemia. The nurse is aware that which group of drugs may cause hypokalemia?
a. Potassium-sparing diuretics
b. Potassium-wasting diuretics
c. Beta-blockers
d. Narcotics

 

 

 

  1. A client’s serum potassium level is 5.4 mEq/L. What intervention may correct this type of potassium imbalance?
a. Restriction of foods containing potassium
b. Administration of sodium bicarbonate (NaHCO3)
c. Administration of insulin and glucose
d. Administration of sodium polystyrene sulfonate (Kayexalate) and sorbitol

 

 

 

  1. A client’s serum potassium level is 6.9 mEq/L. The nurse anticipates that the healthcare provider will order:
a. atropine.
b. sodium bicarbonate (NaHCO3).
c. insulin and glucose.
d. sodium polystyrene sulfonate (Kayexalate) and sorbitol.

 

 

 

  1. In monitoring a client taking potassium supplements, the nurse observes for which signs and symptoms of hyperkalemia?
a. Oliguria, tachycardia, and later bradycardia
b. Soft, flabby muscles
c. Abdominal distention
d. Blurred vision and loss of hearing

 

 

 

  1. A nurse is teaching a client about ways to avoid hypocalcemia. Dietary recommendations indicate that vitamin _____ is necessary for calcium absorption.
a. A
b. B
c. D
d. E

 

 

 

  1. A client’s serum calcium level is 3.7 mEq/L. Concerning this level, the nurse knows that it is:
a. low.
b. normal.
c. high.
d. dangerously high.

 

 

 

  1. A client is receiving D5NSS via a peripheral IV. The client is prescribed to receive calcium gluconate (Kalcinate). The nurse knows that calcium should not be mixed with saline solution. What is the appropriate response from the nurse?
a. Ask the healthcare provider about changing the IV solution to 5% dextrose in water (D5W), because saline encourages calcium loss.
b. Do not give the medication because it is the wrong solution.
c. Report the healthcare provider immediately to the supervisor because it is the wrong solution.
d. Change the IV solution to D5W and report it later to the healthcare provider.

 

 

 

  1. The nurse is aware that which groups of drugs contains magnesium and can cause hypermagnesemia if taken in excess?
a. Laxatives and steroids
b. Laxatives and antacids
c. Antacids and antibiotics
d. Antacids and steroids

 

 

 

  1. A client with congestive heart failure is noted to have gained 17 pounds in the 2 weeks since the last appointment. The nurse is aware that this represents an approximate fluid retention volume of which amount?
a. 5 L
b. 8 L
c. 10 L
d. 15 L

 

 

 

  1. Which sign or symptom may be noted in a client with overhydration?
a. Bradycardia
b. Hypotension
c. Pulmonary congestion
d. Weight loss

 

 

 

  1. A postoperative client enters the postanesthesia care unit and blood studies are done. The client’s serum potassium level is 2.9 mEq/L. What will the nurse do next?
a. Institute seizure precautions.
b. Monitor ECG readings.
c. Draw liver enzyme levels.
d. Elevate the head of the bed.

 

 

 

  1. Which symptom would alert the nurse to the diagnosis of deficient fluid volume?
a. Weight gain
b. Tachycardia
c. Moist mucous membranes
d. Urine output greater than 600 mL/day

 

 

 

  1. The client is experiencing potassium excess and is being treated with 10% calcium gluconate. The client has been diagnosed with cardiac disease. The highest priority action on the part of the nurse is to check the client’s:
a. medications since this drug can lead to digitalis toxicity.
b. pulse frequently since bradycardia is likely to result.
c. pedal pulses frequently and lower extremities for swelling.
d. mental status since alteration in consciousness may occur.

 

 

  1. The client has been ordered Kayexalate as a treatment for potassium excess. The nurse is gathering equipment to administer the medication and recognizes that the drug will be given as a(n):
a. intramuscular injection.
b. intravenous medication.
c. rectal medication.
d. subcutaneous injection.

 

 

 

  1. A client who is taking calcium supplements is concerned about her ability to determine that the supplements are absorbable. The nurse should instruct the client to check the tablet’s absorbability by performing which action?
a. Put 1 tablet into 1 ounce of white vinegar; the tablet should dissolve within 30 minutes.
b. Put 1 tablet into 1 ounce of hydrogen peroxide; the tablet should not dissolve.
c. Put 1 tablet into 1 ounce of alcohol; the tablet should dissolve within 1 hour.
d. Put 1 tablet into 1 ounce of water; the tablet should dissolve within 15 minutes.

 

 

 

MULTIPLE RESPONSE

 

  1. Tetany symptoms result from severe calcium deficit. The nurse checks for symptoms of tetany. Which symptoms are associated with tetany? (Select all that apply.)
a. twitching of the mouth and numbness of the fingers
b. muscle weakness
c. carpopedal spasms
d. laryngeal spasm

 

 

 

 

 

 

 

ESSAY

 

 

  1. A client with cirrhosis is noted to have low serum albumin levels. The client is to receive 200 mL of albumin in 30 minutes. The drop factor for the IV set is 15 gtt/mL. The nurse correctly adjusts the IV rate to what?

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 17: Nutritional Support

 

Test Bank

 

MULTIPLE CHOICE

 

  1. The physician orders nutrient support for a client with a traumatic injury. The nurse recognizes the purpose of this order, which is to:
a. improve cardiac function.
b. enhance wound healing.
c. improve intestinal and liver blood flow.
d. improve general health.

 

 

 

  1. A nurse is evaluating a client for commencement of enteral feedings. The most appropriate client to receive enteral feeding is the client who has _____ bowel sounds.
a. decreased
b. absent
c. intact
d. occasional

 

 

 

  1. Water is an essential component in enteral feedings for the client because it:
a. keeps the solution intact.
b. increases the solution volume.
c. maintains hydration state.
d. decreases the thickness of the solution.

 

 

  1. A client is receiving 300 mL of Isocal every 4 hours by intermittent enteral feedings. What is the optimal method to receive the enteral feeding with this volume?
a. Direct use of a syringe or funnel
b. Infusion pump over 24 hours
c. Gravity drip or infusion pump over 30 to 60 minutes
d. Gravity drip or infusion pump over 8 to 16 hours

 

 

 

  1. What is a complication of total parenteral nutrition (TPN) not found with enteral feelings?
a. Dehydration
b. Aspiration if supine
c. Frequent diarrhea
d. Pneumothorax

 

 

 

  1. A client is to receive amoxicillin (Amoxil, Augmentin) suspension. The nurse recognizes which complication of the medication that is due to its hyperosmolar state?
a. Vomiting
b. Severe headaches
c. Diarrhea
d. Clotting abnormalities

 

 

 

  1. Liquid medications should be diluted to reduce the osmolality of the drug to 500 mOsm. The client is to receive amoxicillin (Amoxil, Augmentin) 250 mg, qid. The medication is available as 50 mg/mL. The osmolality of amoxicillin is 2250 mOsm. How many milliliters of total liquid and medication should the client receive?
a. 5 mL
b. 10 mL
c. 17.5 mL
d. 22.5 mL

 

 

 

  1. The client most likely to be treated with total parenteral nutrition (TPN) is the client who has:
a. gastrointestinal (GI) dysfunction.
b. inadequate nutritional intake.
c. an intact gastrointestinal system.
d. a decreased immune system.

 

 

 

  1. A client has been ordered to be treated with total parenteral nutrition (TPN). For which complications will the nurse monitor the client most closely?
a. Pulmonary embolism
b. Air embolism
c. Nausea and vomiting
d. Ascites

 

 

 

  1. The nurse instructs the client to prevent air embolism with total parenteral nutrition (TPN) by performing the Valsalva’s maneuver. The nurse instruct the client to take a breath, then:
a. breathe rapidly.
b. hold it, and bear down.
c. exhale and bear down.
d. exhale and hold it.

 

 

 

  1. A nutritionist is working with a family discussing nutritional options for a client in a comatose state. Which statement is true of enteral feedings but not true of parenteral feedings?
a. They are more expensive.
b. They have a higher infection rate.
c. They pose a greater risk of aspiration.
d. They can be used with intestinal obstruction.

 

 

 

  1. A nurse has checked the residual in a gastrostomy tube before providing a feeding for an adult client. The previous feeding of 240 mL was given 4 hours ago. The residual was 75 mL. What should the nurse do?
a. Administer the feeding as ordered.
b. Stop the infusion, wait 1 hour, and check the residual again.
c. Hold the feeding and call the physician for orders.
d. Administer half of the ordered feeding and then check residual.

 

 

 

  1. A client has a large episode of diarrhea during an enteral feeding. What should be the first nursing action?
a. Slow the feeding.
b. Stop the feeding.
c. Call the physician.
d. Administer an antidiarrheal agent.

 

 

 

  1. A client is recovering from a cerebrovascular accident (stroke) and is receiving gastrostomy tube feedings. He is placed on aspiration precautions. What independent nursing action can the nurse implement?
a. Thicken the feedings with cereal.
b. Warm the formula.
c. Advance the feeding tube into the duodenum.
d. Elevate the head of the bed.

 

 

 

  1. A client receiving total parenteral nutrition for 3 days becomes disoriented and removes her intravenous line. A new line cannot be inserted for 2 to 3 hours. The nurse should monitor the client for:
a. hypoglycemia.
b. infection.
c. air embolism.
d. hyperglycemia.

 

 

 

  1. A client begins total parenteral nutrition to enhance nutritional status before surgery. The nurse is providing teaching about this treatment. Which statement by the client indicates a need for more teaching?
a. “The TPN fluid is a complete nutritional solution.”
b. “I will urinate a lot because of the fluid and the sugar.”
c. “I can take the IV dressing off in the shower.”
d. “I need my urine and blood checked frequently.”

 

 

 

  1. The most likely candidate for total parenteral nutrition is the client:
a. with a low risk of aspiration.
b. with a well-functioning GI tract.
c. without intravenous access.
d. diagnosed with malnutrition and cancer.

 

 

 

  1. A client is receiving total parenteral nutrition (TPN) via a central line. Which condition predisposes this client to infection?
a. High protein content in the TPN
b. WBC count of 7800/mm
c. Line being in a small IV line
d. Glucose content of the solution

 

 

 

  1. The client is being treated with total parenteral nutrition. He is experiencing sharp chest pain and decreased breath sounds. These symptoms most likely are the result of:
a. fluid overload.
b. infection.
c. air embolism.
d. pneumothorax.

 

 

 

  1. The client is being treated with total parenteral nutrition. She is experiencing cough, dyspnea, neck vein engorgement, chest rales, and weight gain. These symptoms most likely are the result of:
a. pneumothorax.
b. air embolism.
c. infection.
d. fluid overload.

 

 

 

  1. The client is being treated with total parenteral nutrition. The nurse is monitoring the client closely for evidence of infection during the first week of treatment. The nurse recognizes that the dressing over the catheter insertion site should be changed every _____ hours.
a. 48
b. 24
c. 16
d. 8

 

 

 

  1. The client is being treated with enteral feeding. Before administering the feeding, the nurse plans to elevate the head of the client’s bed _____ degrees.
a. 90
b. 45
c. 30
d. 15

 

 

 

MULTIPLE RESPONSE

 

  1. A nurse received a client from the PACU after a major bowel resection. The client was started on total parenteral nutrition with 40% glucose in the PACU. In the report, the PACU nurse instructs that the patient must be monitored for hyperglycemia. What are the manifestations of hyperglycemia? (Select all that apply.)
a. Increased urine output
b. Headache
c. Dry mucous membranes
d. Diaphoresis
e. Lethargy
f. Glycosuria
g. Thirst

 

 

 

  1. A client is receiving total parenteral nutrition (TPN). The nurse assesses for which potential complications of TPN? (Select all that apply.)
a. Hyperglycemia
b. Diarrhea
c. Hypervolemia
d. Immunosuppression
e. Infection
f. Aspiration
g. Air embolism
h. Hypoglycemia

 

 

 

==

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 18: Adrenergic Agonists and Adrenergic Blockers

 

Test Bank

 

MULTIPLE CHOICE

 

  1. The drugs that mimic the effect of norepinephrine are called:
a. sympathomimetics, or adrenergic agonists.
b. sympatholytics, or adrenergic drugs.
c. sympathomimetics, or adrenergic blockers.
d. sympatholytics, or adrenergic blockers.

 

 

 

  1. The actions of the mixed-acting sympathomimetics are _____ the adrenergic receptor sites and _____ the release of norepinephrine.
a. stimulating; inhibiting
b. stimulating; stimulating
c. inhibiting; inhibiting
d. inhibiting; stimulating

 

 

 

  1. A client was stung by a bee. This is the third bee sting the client has received, and the client complains of shortness of breath. What is the adrenergic drug used in emergencies to combat a life-threatening allergic reaction?
a. Norepinephrine (Levophed)
b. Epinephrine (Adrenalin)
c. Terbutaline (Brethine)
d. Propranolol (Inderal)

 

 

 

  1. A client experiencing shortness of breath associated with asthma is given epinephrine (Adrenalin). This medication is considered a nonselective adrenergic drug because it innervates ________ receptor sites.
a. alpha-adrenergic
b. beta-adrenergic
c. alpha-, beta1-, and beta2-adrenergic
d. beta1– and beta2-adrenergic

 

 

  1. A nurse receives an order to administer epinephrine (Adrenalin) orally to a client. What is the highest priority action on the part of the nurse?
a. Call the physician to question the order.
b. Administer the medication as ordered.
c. Call the pharmacist for clarification of the order.
d. Hold the order and continue to monitor the client.

 

 

 

  1. A client with asthma is given albuterol sulfate (Proventil), a selective adrenergic drug that stimulates the beta2-receptor site. Which response should the nurse expect to see in the client?
a. Bronchoconstriction
b. Bronchodilation
c. Decreased heart rate
d. Increased blood pressure

 

 

 

  1. Albuterol sulfate (Proventil) has a short half-life and duration of action. Based on this information, what should the nurse select as an appropriate dosing schedule for this drug?
a. Once a day
b. Once every other day
c. 3 or 4 times a day
d. 2 times a day

 

 

 

  1. Alpha-adrenergic blockers promote vasodilation. The nurse anticipates what expected therapeutic response from the client taking alpha-adrenergic blockers?
a. Increased blood pressure
b. Decreased blood pressure
c. Decreased pulse rate
d. Rapid respiration

 

 

 

  1. The client has been ordered to receive a beta-adrenergic blocker. The nurse should anticipate that the client will exhibit:
a. increased pulse rate and bronchoconstriction.
b. decreased pulse rate and bronchodilation.
c. increased pulse rate and bronchodilation.
d. decreased pulse rate and bronchoconstriction.

 

 

 

  1. A client with asthma is receiving metoprolol (Lopressor), a beta blocker for hypertension. The client asks if metoprolol will affect her asthma. What is the best response from the nurse?
a. “Metoprolol may cause bronchoconstriction, and is questionable if it will help decrease blood pressure.”
b. “Metoprolol decreases pulse rate and thus blood pressure, but it should not have an effect on the bronchioles.”
c. “Metoprolol causes bronchodilation and increased pulse rate, so refuse the drug.”
d. “I’ll inform the healthcare provider that you should not take metoprolol.”

 

 

 

  1. Which instruction will the nurse include in a teaching plan for a client taking metoprolol (Lopressor) for treatment of hypertension?
a. Rise slowly from a supine or sitting position.
b. Limit fluid intake while taking this drug.
c. Frequent ophthalmic exams are encouraged.
d. Use lozenges if a dry cough occurs.

 

 

 

  1. Client teaching for patients receiving beta blockers includes instructing the client:
a. to take the beta blocker when symptoms occur.
b. to have blood pressure and pulse rate checked monthly or quarterly.
c. that GI upset is a common problem and if it occurs to stop the drug.
d. not to abruptly stop taking the beta blocker because of the possible occurrence of rebound hypertension.

 

 

 

  1. A nurse is teaching a client how to use phenylephrine (Neo-Synephrine) nasal spray. To avoid systemic absorption, the nurse teaches the client to:
a. apply pressure to the nose after spraying.
b. administer the spray while in the supine position.
c. insert the spray while sitting up.
d. exhale deeply while injecting the nasal spray.

 

 

 

  1. A client is discharged on beta blockers. Which skill is essential for the client’s family to learn?
a. How to prepare a low-sodium diet
b. Assessments to detect fluid retention
c. How to monitor heart rate and blood pressure
d. Early signs of changing level of consciousness

 

 

 

  1. A nurse is infusing dopamine (Intropin) intravenously. The nurse is aware that infiltration of this medication may lead to tissue necrosis. What is an early sign of intravenous infiltration?
a. Red streak following the course of the vein
b. Swelling at the IV site
c. Warmth at the insertion site
d. Bleeding at the insertion site

 

 

 

  1. The client has been started on a treatment regimen that includes albuterol. The nurse should anticipate seeing a decrease in the client’s serum _____ level.
a. calcium
b. potassium
c. magnesium
d. glucose

 

 

 

  1. The client has been started on a treatment regimen that includes atenolol. She complains to the nurse of experiencing weakness. Which is the best response from the nurse?
a. “I will hold your next dose of the medication. You are reaching a toxic level.”
b. “I will increase your next dose of the medication. Your level is too low.”
c. “This is an adverse reaction to the medication. I will stop the drug.”
d. “This is a side effect of the medication. I will notify your physician.”

 

 

 

  1. The client comes to a health clinic asking for Sudafed. He tells the nurse that he has a history of diabetes mellitus. What is the most accurate response from the nurse?
a. “Sudafed is a safe drug to give to a client who is a diabetic.”
b. “Sudafed should not be used by a client who is a diabetic.”
c. “You can use Sudafed, but you must monitor your blood sugar very closely.”
d. “You can use Sudafed, but you will probably experience hypoglycemia.”

 

 

  1. The client has been placed on a therapeutic regimen that includes Regitine. She tells the nurse that she routinely takes St. John’s wort for depression. What should the nurse expect to see as a result of the client taking these medications?
a. Worsening of the hypotensive effects of the Regitine
b. Client experiencing bradycardia
c. Worsening of the hypertensive effects of the Regitine
d. Client experiencing of tachycardia

 

 

 

MULTIPLE RESPONSE

 

  1. Adrenergic agents have specific effects on the body. What are the actions of adrenergic medications? (Select all that apply.)
a. Dilate pupils.
b. Increase heart rate.
c. Stimulate gastric muscle.
d. Dilate blood vessels.
e. Dilate bronchioles.
f. Relax uterine muscles.
g. Contract the bladder.

 

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 19: Cholinergic Agonists and Anticholinergics

 

Test Bank

 

MULTIPLE CHOICE

 

  1. The nurse is reviewing the history of a client who has been prescribed tolterodine tartrate (Detrol, Detrol LA) for treatment of incontinence. The nurse plans to contact the health care provider if the client has:
a. cataracts.
b. hyperthyroidism.
c. narrow-angle glaucoma.
d. parkinsonism.

 

 

 

  1. A client is receiving bethanechol chloride (Urecholine) as part of his treatment regimen. He is experiencing swallowing difficulties. The highest priority action on the part of the nurse is to contact the physician to administer the drug by _____ injection.
a. intramuscular
b. intravenous
c. subcutaneous
d. intradermal

 

 

 

  1. The client that would be a poor candidate for treatment with bethanechol chloride (Urecholine) is the client who is experiencing:
a. severe bradycardia and hypotension.
b. tachycardia and hypertension.
c. urinary retention and abdominal distention.
d. hypertension and urinary retention.

 

 

 

  1. Reversible cholinesterase inhibitors can be an effective treatment for glaucoma because of which action of the drug?
a. It causes the eyeball to decrease in size.
b. It causes the aqueous humor of the eye to expand.
c. It produces pupillary constriction.
d. It produces pupillary dilation.

 

 

 

  1. The client has myasthenia gravis. The highest priority client teaching is:
a. instructing the client to take the drug on a strict schedule to avoid respiratory muscle weakness.
b. informing the client if a dose of the drug is missed to double the drug dose when the next dose is scheduled.
c. instructing the client that if muscle weakness occurs, to rest, and if it persists to call the healthcare provider the next day.
d. informing the client that if respiratory distress occurs, rest, double the drug dose, and call the healthcare provider.

 

 

 

 

 

  1. The client has been diagnosed with early-stage Alzheimer’s dementia. What cholinesterase inhibitor is most likely to be ordered for this client?
a. Ambenonium chloride (Mytelase)
b. Bethanechol chloride (Urecholine)
c. Atropine sulfate
d. Donepezil (Aricept)

 

 

 

  1. A nurse is teaching a client about bethanechol hydrochloride (Urecholine). The nurse informs the client that this drug warrants which precaution?
a. Rising slowly from lying positions
b. Counting pulse rate frequently to assess for bradycardia
c. Avoiding diarrhea by eating binding foods
d. Maintaining aspiration precautions because of excess saliva

 

 

 

  1. The client who is being treated with an anticholinergic medication should receive which instruction?
a. Encourage the use of alcohol before bedtime for sleep disorders.
b. Suggest hard candy, chewing gum, and oral hygiene for dry mouth.
c. Instruct the client to report dizziness and a slow pulse rate immediately.
d. Instruct the client to avoid lifting heavy objects.

 

 

 

  1. The client that would be a poor candidate for treatment with an atropine-like drug is the client who has:
a. parkinsonism.
b. a peptic ulcer.
c. cirrhosis.
d. glaucoma.

 

 

 

  1. Which response can the nurse expect to see in the client who has parkinsonism and is being treated with anticholinergics?
a. Decreased cognition
b. Increased muscle tone
c. Diuresis
d. Decreased tremors and rigidity

 

 

 

  1. A client with nausea and vomiting has been prescribed an antihistamine and an anticholinergic. The nurse anticipates that which expected side effect of these medications will be observed in the client?
a. Drowsiness and dry mouth
b. Bradycardia and fatigue
c. Tachycardia and dyspnea
d. Abdominal cramps and nausea

 

 

 

  1. The nurse notes that a client with glaucoma has been ordered an anticholinergic medication. What is the highest priority action on the part of the nurse?
a. Administer the medication; this is appropriate for this client.
b. Check the client’s allergy history since it can cause anaphylaxis.
c. Call the pharmacist; the drug interacts with many other medications.
d. Call the physician; this is an inappropriate drug for this client.

 

 

 

  1. A client is ordered bethanechol chloride (Urecholine) for urinary retention. A nurse is adding up the client’s intake and output for the 8-hour shift. The client’s I = 850 mL, O = 350 mL. What should the nurse do?
a. Administer an extra dose of bethanechol.
b. Palpate the client’s bladder.
c. Increase the client’s fluid intake.
d. Continue the plan of care.

 

 

 

  1. A client experiences bradycardia as a result of vagal stimulation. What will the nurse expect to administer?
a. Bethanechol chloride (Urecholine)
b. Benztropine (Cogentin)
c. Metoclopramide (Reglan)
d. Atropine sulfate (atropine)

 

 

 

  1. The client has been started on Detrol LA. She is also being treated with a tricyclic antidepressant. What effect should the nurse anticipate from the interaction of the medications?
a. Increased action of the Detrol LA
b. Decreased action of the Detrol LA
c. Increased action of the tricyclic medication
d. Decreased action of the tricyclic medication

 

 

 

  1. The client has been started on Detrol LA and tells the nurse that he is experiencing constipation. What is the highest priority action on the part of the nurse?
a. Hold the next dose of the medication; this is an adverse reaction.
b. Administer the drug: this is an expected response to the drug.
c. Notify the physician; this is a side effect of the medication.
d. Call the pharmacist; this is evidence of toxicity of the drug.

 

 

 

  1. The client has been started on Artane. The nurse notes that the client’s bowel sounds are decreasing. What is the highest priority action on the part of the nurse?
a. Administer the drug; this is an expected reaction.
b. Administer the drug; this is an expected side effect.
c. Hold the drug; this is an adverse reaction to the drug.
d. Hold the drug; this is a life-threatening response.

 

 

 

  1. The nurse notes that Artane has been ordered as a preoperative medication for the client. What is the highest priority action on the part of the nurse?
a. Administer the medication; this is an expected preoperative medication for the client.
b. Administer the drug cautiously; anaphylaxis can occur quickly with this drug.
c. Call the physician to question the order based on the client’s allergy history.
d. Call the physician to question the order; this is not a usual preoperation medication.

 

 

 

  1. The client is being treated with a large dose of an anticholinergic medication. She complains of feeling disoriented. What should be the nurse’s highest priority action based on the client’s complaint?
a. Call the pharmacist; the dose of the medication may be incorrect.
b. Call the physician; the medication is causing an adverse reaction.
c. Call the pharmacist; the medication may be reaching a toxic level.
d. Call the physician; the medication is causing an expected side effect.

 

 

 

MULTIPLE RESPONSE

 

  1. Cholinergic agents have specific effects on the body. What are the actions of cholinergic medications? (Select all that apply.)
a. Dilate pupils.
b. Decrease heart rate.
c. Stimulate gastric muscle.
d. Dilate blood vessels.
e. Dilate bronchioles.
f. Increase salivation.
g. Constrict pupils.

 

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 20: Central Nervous System Stimulants

 

Test Bank

 

MULTIPLE CHOICE

 

  1. A nurse is teaching a group of clients about narcolepsy. The most important concept that the nurse should relay to the client is that narcolepsy is characterized by:
a. falling asleep during early morning hours.
b. falling asleep during normal waking hours.
c. waking up during sleep.
d. inability to fall asleep.

 

 

 

  1. A client with narcolepsy is being treated with modafinil (Provigil). The nurse anticipates which expected response from the drug?
a. An increase in the amount of time the client feels awake
b. Increased effectiveness when given primarily after the evening meal
c. Sleep induction
d. Sleep paralysis if taken at bedtime

 

 

 

  1. What is the best time to administer amphetamines for maximum effectiveness?
a. At bedtime
b. 1 to 2 hours before sleep
c. 3 to 4 hours before sleep
d. 6 to 8 hours before sleep

 

 

 

  1. A client discloses to a nurse that he has taken amphetamines for 5 years for weight control. The nurse teaches the client that long-term use of amphetamines lead to:
a. diarrhea.
b. cardiac dysrhythmias.
c. urinary retention.
d. rash.

 

 

 

  1. A pediatric nurse admits a child who has a history of ADHD. The nurse is aware that ADHD may display as:
a. poor coordination and abnormal electroencephalogram (EEG).
b. abnormal EEG and decrease in intelligence.
c. minimal brain dysfunction and marked decrease in intelligence.
d. developmental delay and poor coordination.

 

 

 

  1. The parents of a 6-year-old child diagnosed with ADHD will most typically describe their child’s behavior as:
a. a learning disorder and muscle paralysis.
b. nervousness and sleeplessness.
c. hyperactivity and decreased attention span.
d. hyperactivity and nervousness.

 

 

 

  1. The nurse is deciding on a dosage schedule for methylphenidate (Ritalin). The nurse recognizes that which time is the most appropriate to administer this drug for maximum effectiveness?
a. Before breakfast or lunch
b. With meals
c. After dinner
d. At bedtime

 

 

 

  1. A client with ADHD is prescribed methylphenidate (Ritalin). Based on the half-life of the drug, how often should the nurse administer the drug?
a. Daily
b. Twice a day
c. Every 8 hours
d. Every 12 hours

 

 

 

  1. A client states that he is taking an over-the-counter (OTC) appetite suppressant. Clinical teaching should include that:
a. OTC appetite suppressants are safe for daily use.
b. appetite suppressants should be taken for no more than 4 to 6 months.
c. an OTC amphetamine group frequently does not cause tolerance or dependence.
d. appetite suppressants should be taken only with medical approval.

 

 

 

  1. A college student expresses to the health center nurse that he has been taking appetite suppressants for 8 years. The nurse recognizes that long-term use of anorexiants may result in which severe side effect?
a. Heart palpitations
b. Hypotension
c. Drowsiness
d. Abdominal cramps

 

 

 

  1. A client enters the emergency department with a suspected drug overdose. The nurse anticipates that which CNS respiratory stimulant will be used to treat the client?
a. Doxapram (Dopram)
b. Sumatriptan (Imitrex)
c. Methamphetamine (Desoxyn)
d. Pemoline (Cylert)

 

 

 

  1. A client complains of a mild migraine headache. What treatment may the healthcare provider suggest?
a. Opioid analgesics (e.g., meperidine [Demerol])
b. Analgesics (e.g., acetaminophen, ibuprofen)
c. Ergotamine tartrate
d. Serotonin1-receptor agonists (e.g., sumatriptan succinate [Imitrex])

 

 

  1. The client complains of a severe migraine headache. The nurse anticipates that the physician will order:
a. opioid analgesics.
b. nonnarcotic analgesics.
c. ergotamine tartrate.
d. serotonin1-receptor agonists (triptans).

 

 

 

  1. A client is 4 months pregnant and is sharing with the nurse her frustrations with regard to weight gain. The client asks about anorexiants. The nurse’s response is based on which information?
a. Low-dose appetite suppressants are safe during pregnancy.
b. Appetite suppressants can be taken while nursing, but not while pregnant.
c. Appetite suppressants are not safe during pregnancy or while nursing.
d. Research is inconclusive about the safety of appetite suppressants during pregnancy.

 

 

 

  1. A school nurse is caring for an adolescent diagnosed with migraine headaches. Which nursing intervention is most appropriate during an acute migraine?
a. Maintain bright lights in the room.
b. Administer sumatriptan succinate (Imitrex).
c. Obtain a complete headache history.
d. Provide ordered opioid analgesic.

 

 

 

  1. A newborn with apnea of prematurity is treated with caffeine. Which condition would indicate to the nurse that the treatment was effective?
a. Respiratory rate of 32 to 40 breaths/minute
b. Heart rate of 80 to 100 beats/minute
c. Respiratory rate of 20 to 30 breaths/minute
d. Heart rate of 110 to 130 beats/minute

 

 

 

  1. A nurse is teaching the family of a child with ADHD about her diet and medications. The child is prescribed methylphenidate (Ritalin) every day. In teaching about the client’s diet, it is most important that the nurse encourage the child to avoid which foods and/or drinks?
a. High-sodium foods
b. High-sugar foods and drinks
c. High-fat foods
d. Caffeinated foods and drinks

 

 

 

  1. A client suffers from migraine headaches and is ordered to receive sumatriptan succinate (Imitrex). The client asks why the medication works. The nurse explains that this medication:
a. dilates cerebral vessels to increase cerebral blood flow.
b. causes vasoconstriction to relieve migraine attacks.
c. increases blood flow and oxygen to the brain.
d. decreases blood pressure in order to decrease oxygen to the brain.

 

 

 

  1. The client has been placed on Ritalin. He is already being treated with Coumadin. The nurse anticipates that the combination of the two drugs will have a(n) _____ in the effect of the _____.
a. increase; Coumadin
b. decrease; Coumadin
c. increase; Ritalin
d. decrease; Ritalin

 

 

 

  1. The nurse is caring for a 5-year-old child who has been placed on Ritalin. What is the highest priority action on the part of the nurse?
a. Administer the medication as ordered by the physician.
b. Monitor the client closely during administration.
c. Hold the medication and call the physician.
d. Call the pharmacist to verify the dosage of the drug.

 

 

 

  1. The client is an older adult who has been started on Provigil. The nurse anticipates that the dosage of the drug will need to be:
a. doubled.
b. cut in half.
c. decreased.
d. increased.

 

 

 

ESSAY

 

 

  1. A newborn is ordered to receive caffeine to stimulate respiratory activity. The medication order reads “caffeine 0.5 mg/kg.” The infant weighs 8.8 pounds. The medication is available in a 20 mg/mL elixir. How much should the infant receive?

 

 

=======================================================

 

Kee: Pharmacology, 7th Edition

 

Chapter 21: Central Nervous System Depressants

 

Test Bank

 

MULTIPLE CHOICE

 

  1. A nurse is teaching a client measures to help relieve sleeplessness. Which would be the highest priority teaching point during the instructional session?
a. Avoid caffeine-containing beverages before sleep.
b. Perform strenuous exercise before bedtime.
c. Drink lots of fluids before bedtime.
d. Eat a heavy meal before bedtime.

 

 

 

 

  1. A client tells the nurse that she no longer wants to take hypnotic agents prescribed to help her sleep. The nurse’s instructions are based on the premise that abruptly discontinuing a high dose of hypnotic taken over a long period may lead to which issue?
a. Drug dependence
b. Drug tolerance
c. Withdrawal symptoms
d. Hypnotic rebound

 

 

 

  1. A client who takes an intermediate- or long-acting hypnotic agent complains to the nurse of experiencing residual drowsiness and impaired reaction time on awakening. The nurse recognizes that the client is most likely experiencing which issue?
a. Hangover
b. Dependence
c. Tolerance
d. Depression

 

 

 

  1. A client takes hypnotics over 4 weeks. The client is informed by the nurse that long-term use may lead to rapid eye movement (REM) rebound. The nurse defines REM rebound for the client as:
a. the return of dreaming to normal levels using prolonged hypnotic therapy.
b. the suppression of dreaming in clients taking hypnotics.
c. nightmares or vivid dreaming when the hypnotic is stopped after prolonged use.
d. the decreased efficacy that occurs after 2 weeks of hypnotic use.

 

 

 

  1. A client is ordered a preoperative medication for preanesthesia and sedation. The nurse anticipates that the healthcare provider will order:
a. secobarbital (Seconal).
b. mephobarbital (Mebaral).
c. ramelteon (Rozerem).
d. flurazepam (Dalmane).

 

 

 

  1. A client is ordered to receive temazepam (Restoril). The nurse is preparing an instructional session for the client on the medication. When instructing the client on the action of the medication, the nurse tells her that this medication is known as a(n):
a. barbiturate.
b. piperazinedione.
c. benzodiazepine.
d. anorexiant.

 

 

 

  1. The nurse should instruct clients taking a hypnotic for several weeks that hypnotic use should be gradually withdrawn because:
a. increased drowsiness may result.
b. withdrawal symptoms may be avoided.
c. mental depression may be avoided.
d. gastric irritation may be avoided.

 

 

 

  1. A client is ordered to receive benzodiazepine hypnotics. Client teaching for clients taking benzodiazepine hypnotics includes which instruction?
a. Avoid taking alcohol and antidepressants with a benzodiazepine hypnotic.
b. Avoid taking cardiac glycosides such as digoxin with the hypnotic.
c. Take the drug during nocturnal awakenings.
d. Take the drug immediately after the evening meal.

 

 

 

  1. What does the rationale for use of balanced anesthesia with a client include?
a. A desire for a slow induction of anesthesia to maintain the anesthetic state
b. A reduction in the amount of drug to maintain the desired state of anesthesia
c. The need to minimize adverse reactions through maximizing side effect
d. The need for increased respiratory depression during the surgical period

 

 

 

  1. The client has been ordered an intravenous anesthetic as part of inducing anesthesia. The nurse recognizes that this type of anesthetic is selected because of its _____ onset and _____ duration of action.
a. rapid; short
b. slow; short
c. rapid; long
d. slow; long

 

 

 

  1. A client is to receive lidocaine (Xylocaine). The nurse is aware that lidocaine is frequently used as _____ anesthesia.
a. spinal
b. intravenous
c. local
d. general

 

 

 

  1. The nurse instructs a client prescribed pentobarbital (Nembutal) to avoid taking which herbal preparation?
a. Chamomile
b. Kava kava
c. Ginger
d. Goldenseal

 

 

 

  1. After spinal anesthesia, what is the highest priority action of the nurse?
a. Elevate the head of the bed immediately when the client returns from surgery.
b. Ambulate the client as soon as possible to aid in the excretion of the spinal anesthetic.
c. Have the client change positions hourly to increase the spinal fluid loss.
d. Instruct the client to remain flat for 6 to 8 hours to decrease the loss of spinal fluid.

 

 

 

  1. A client is ordered to receive zolpidem tartrate (Ambien) as a hypnotic agent before surgery. Because of the impact of food on the absorption of this medication, the nurse is aware that the medication should be administered _____ dinner.
a. 1 hour before
b. during
c. 1 hour after
d. 3 hours after

 

 

 

  1. A client is ordered to receive zolpidem tartrate (Ambien) the night before her surgery. The client asks why this is necessary. What is the nurse’s response?
a. “Clients typically don’t sleep well the night before a major surgery.”
b. “It will dry up the secretions in your mouth before surgery.”
c. “It will help you get the rest you need before your surgery.”
d. “It is considered anesthesia and is necessary for your surgery.”

 

 

  1. The client is started on Seconal Sodium. He complains to the nurse of dizziness. The highest priority action on the part of the nurse is to call the:
a. pharmacist to clarify the dosage and administer the dosage as ordered.
b. physician; the client is experiencing a side effect of the medication.
c. physician; the client is experiencing a life-threatening reaction.
d. pharmacist for clarification and hold the drug until orders are received.

 

 

 

  1. The client has been started on Halcion and tells the nurse that she is concerned about developing a tolerance for the drug. What is the nurse’s highest priority instruction to the client?
a. “Do not use the medication for longer than 7 to 10 days at a time.”
b. “Do not stop the medication for any reason.”
c. “Do not use the medication for longer than 6 weeks.”
d. “Do not take any other medication when taking this drug.”

 

 

 

ESSAY

 

  1. A client is ordered to receive naloxone (Narcan). The client weighs 20 kg and is ordered to receive 0.01 mg/kg. The medication is available as 400 mcg/mL. How much should the nurse administer?

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 22: Anticonvulsants

 

Test Bank

 

MULTIPLE CHOICE

 

  1. A client is ordered to receive phenytoin (Dilantin). The client’s serum phenytoin level is noted to be 15 mcg/mL. How does the nurse interpret this level?
a. 5 to 10 mcg/mL is subnormal.
b. 8 to 15 mcg/mL is above normal.
c. 10 to 20 mcg/mL is therapeutic.
d. 15 to 30 mcg/mL is toxic.

 

 

 

  1. A client taking phenytoin (Dilantin) is admitted to the emergency department with a level of 30 mcg/mL. The nurse would evaluate for the severe side effect of:
a. gingival hyperplasia.
b. abdominal distention.
c. abdominal cramps.
d. hypertension.

 

 

 

  1. A client taking anticonvulsants for epilepsy should receive which instruction from the nurse?
a. “The medication is usually taken for a lifetime.”
b. “The medication is taken until you are seizure-free.”
c. “Seizures are unpredictable, and therefore so is the drug regimen.”
d. “Seizure disorders may be cured with anticonvulsants.”

 

 

 

  1. A nurse is teaching a client about her health plan when taking phenytoin (Dilantin). Which instruction would not be included in the teaching plan?
a. “Avoid use of oral contraceptives.”
b. “Assess output daily.”
c. “Drink alcoholic beverages sparingly.”
d. “Obtain a Medic Alert bracelet.”

 

 

 

  1. A client has been taking phenytoin (Dilantin) for 10 years. This client should be evaluated for:
a. hypoglycemia.
b. hyperglycemia.
c. hypertension.
d. status epilepticus.

 

 

 

  1. A child enters the emergency department. The paramedics report that the child has been having a seizure that has lasted for 45 minutes. In addition to securing and maintaining an airway, what is a priority intervention on the part of the nurse?
a. Phenobarbital (Luminal)
b. Diazepam (Valium)
c. Phenytoin (Dilantin)
d. Valproic acid (Depakene)

 

 

 

  1. The client with ________ would not be a candidate for treatment with valproic acid (Depakene).
a. a liver disorder
b. cardiac dysfunction
c. a gastrointestinal tract disorder
d. a thyroid dysfunction

 

 

 

  1. Gastric irritation may occur when taking ethosuximide (Zarontin). The nurse suggests taking the drug:
a. before meals.
b. 2 hours after meals.
c. at bedtime.
d. at mealtime or immediately after the meal.

 

 

 

  1. A child is brought to the healthcare provider’s office. The child has been receiving phenytoin (Dilantin) for seizure activity. The family reports that despite the child’s previously reported controlled seizures, the child has been seizing two or three times a day. The nurse would anticipate that the:
a. child’s medication will be changed.
b. child will be admitted to the hospital.
c. child will be placed on nasogastric medications.
d. child’s phenytoin level will be drawn.

 

 

 

  1. Which of the following dietary restrictions is indicated with carbamazepine (Tegretol)?
a. Limit foods high in vitamin K.
b. Restrict acid-ash foods.
c. Maintain a high-fiber diet.
d. Do not drink grapefruit juice.

 

 

 

  1. A client with a known seizure disorder is treated with several anticonvulsant medications. The client confides in the nurse, stating that he also has a strong belief in complementary medicine and takes several herbal supplements. Which is an appropriate response by the nurse?
a. “Check with your healthcare provider to ensure that there are no harmful drug interactions.”
b. “Most herbal supplements are safe medications with anticonvulsants.”
c. “No herbal supplements should be taken with prescription medications.”
d. “You need to check the herbal labels to make sure that this is okay.”

 

 

 

  1. A client with a new seizure disorder is ordered to receive phenobarbital (Luminal) for seizures. The nurse would expect:
a. a high body temperature.
b. hypertension.
c. lethargy.
d. decreased urine output.

 

 

 

  1. A client with a known seizure disorder enters the emergency department. The nurse notes that his gums are swollen and bleeding. What is a priority nursing intervention?
a. Draw a bleeding time.
b. Assess the client’s dental hygiene.
c. Assess for mucositis.
d. Draw a phenytoin level.

 

 

 

  1. A client is ordered to receive an anticonvulsant for seizure activity. Which side effects are most prevalent with clients who take drugs in this class?
a. Drowsiness and lethargy
b. Nausea and vomiting
c. Weight loss and anorexia
d. Hypertension and tachycardia

 

 

 

  1. A client enters the emergency department in status epilepticus. The nurse anticipates the administration of:
a. phenobarbital (Luminal).
b. phenytoin (Dilantin).
c. valproic acid (Depakene).
d. diazepam (Valium).

 

 

 

 

  1. A client with a known seizure disorder is being treated with phenytoin (Dilantin). The client becomes pregnant. Which recommendation would be appropriate for the nurse to make?
a. “Contact your healthcare provider right away; you should not take Dilantin while pregnant.”
b. “Make certain that your healthcare provider is aware that you are taking Dilantin through the first trimester.”
c. “Antiepileptic agents need to be taken during pregnancy to avoid the effect of seizure activity on the fetus.”
d. “Dilantin is safe during pregnancy as long as you maintain adequate hydration.”

 

 

 

  1. A client has been receiving phenytoin (Dilantin) for 15 years. The nurse implements which diagnostic test to assess for a common adverse reaction to long-term medication use?
a. Fasting blood glucose level
b. Chest x-ray
c. Voiding cystourethrogram
d. BUN and creatinine

 

 

 

  1. A nurse is providing teaching for a client taking phenytoin (Dilantin). Which client statement indicates a good understanding of the teaching?
a. “Concentrated urine means a life-threatening disorder.”
b. “Alcohol is contraindicated with Dilantin.”
c. “Dilantin should be taken on an empty stomach.”
d. “Dilantin may be discontinued because seizure rebound is uncommon.”

 

 

  1. The client has been started on phenytoin. He reports experiencing reddish-colored urine. What is the nurse’s highest priority intervention?
a. Report this symptom to the physician; this is an adverse reaction.
b. Instruct the client to stop the medication; this is a life-threatening reaction.
c. Report this symptom to the physician; this indicates toxicity of the medication.
d. Instruct the client that this is an expected side effect of the medication.

 

 

 

  1. The client has been started on valproic acid. Her level of the medication is drawn and is found to be 60 mcg/mL. The nurse notes that this is a(n) _____ level.
a. toxic
b. therapeutic
c. subnormal
d. above-normal

 

 

 

  1. The client has been started on phenytoin and reports to the nurse that he also takes ginkgo. What is the most accurate response from the nurse?
a. “Ginkgo can decrease the effectiveness of phenytoin.”
b. “Ginkgo can increase the effectiveness of phenytoin.”
c. “Ginkgo can cause an anaphylactic reaction to phenytoin.”
d. “Ginkgo can cause phenytoin to reach a toxic level.”

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 23: Drugs for Neurologic Disorders: Parkinsonism and Alzheimer’s Disease

 

Test Bank

 

MULTIPLE CHOICE

 

  1. The client has been prescribed carbidopa-levodopa (Sinemet). The highest priority instruction for the client is to avoid eating:
a. oranges.
b. lima beans.
c. spinach.
d. watermelon.

 

 

 

  1. In parkinsonism, what is the neurotransmitter that is in excess, causing excitation and movement disorders?
a. Acetylcholine
b. Norepinephrine
c. Epinephrine
d. Dopamine

 

 

 

  1. A client is admitted with the diagnosis of Parkinson’s disease. The nurse is vigilant for which symptom?
a. Gastrointestinal upset
b. Inability to remember name
c. Bradykinesia
d. Disorientation

 

 

 

  1. A client is diagnosed with parkinsonism. He is ordered to receive levodopa (L-dopa) 750 mg qid. What side effects should the nurse watch for?
a. Cardiac dysrhythmias, behavioral changes, and orthostatic hypotension
b. Increased urination, increased libido, and muscle weakness
c. Hypotension, anorexia, and dyspnea
d. Decreased libido, hypertension, and palpitations

 

 

 

  1. The client with ________ would not be a candidate for treatment with Sinemet.
a. narrow-angle glaucoma
b. gastrointestinal distention
c. bradycardia
d. urinary frequency

 

 

 

  1. What antiviral drug is used to decrease parkinsonism symptoms?
a. Amantadine (Symmetrel)
b. Pergolide (Permax)
c. Bromocriptine (Parlodel)
d. Selegiline (Eldepryl)

 

 

 

  1. A client is diagnosed with Alzheimer’s disease. In developing a teaching plan for the client’s family members, the nurse bases the plan on the idea that Alzheimer’s disease is a(n):
a. curable dementia-type illness.
b. form of mental illness.
c. chronic, progressive condition.
d. acute, treatable disease.

 

 

 

  1. Tacrine (Cognex) has a short half-life. The nurse would anticipate that this medication would be ordered how often?
a. Every other day
b. Daily
c. bid
d. qid

 

 

 

  1. Tacrine (Cognex) is ordered for a client. Because of its most life-threatening adverse reaction, the nurse is aware that which levels should be frequently evaluated?
a. Liver enzymes
b. BUN and creatinine levels
c. White blood cell count
d. Serum albumin levels

 

 

 

  1. Which is a realistic goal regarding medication for the client with advanced Alzheimer’s disease?
a. The client will demonstrate independent medication administration behaviors throughout the course of the disease.
b. With assistance, the client will receive medications at appropriate times throughout the course of the illness.
c. The client will demonstrate progressive improvement in cognitive function for the next year.
d. The client will report a decrease in memory loss by the next healthcare provider visit.

 

 

 

  1. A client is being treated with carbidopa/levodopa (Sinemet) as a treatment for Parkinson’s disease. Which symptom indicates a positive response to the medication?
a. Increase in ability to remember name and recent events
b. Decrease in tremoring and bradykinesia
c. Acceleration of random movements
d. Decrease in metabolic rate and vital signs

 

 

 

  1. A client with Alzheimer’s disease receives tacrine (Cognex). Her son is commenting on his mother’s condition. Which comment indicates an expected positive effect from this medication?
a. “My mother is less unstable on her feet.”
b. “My mother is not deteriorating at this time.”
c. “My mother seems to be cured of her Alzheimer’s.”
d. “My mother is no longer at risk of the effects of Alzheimer’s.”

 

 

 

  1. A client with Parkinson’s disease is receiving levodopa (L-dopa) to reduce symptoms. What would indicate the effectiveness of the medication?
a. Increasing tremoring
b. Decreasing pill-rolling
c. Hyperactivity
d. Bradykinesia

 

 

 

  1. The client has been placed on Tacrine. What is the best time for the nurse to administer the medication?
a. 8:00 PM
b. 12:30 PM
c. 2:00 PM
d. 5:30 PM

 

 

 

  1. The client has been ordered treatment with Sinemet. He tells the nurse that he has previously been diagnosed and treated for malignant melanoma. What is the best response from the nurse?
a. “The medication does not have any effect on diseases such as malignant melanoma.”
b. “The medication is contraindicated when you have had malignant melanoma.”
c. “The medication will prevent a recurrence of malignant melanoma.”
d. “The medication may lead to a recurrence of malignant melanoma.”

 

 

 

  1. The client has been started on Sinemet. She is also being treated with an MAO inhibitor medication. The nurse anticipates that which of the client’s vital signs should be most closely monitored?
a. Blood pressure
b. Apical pulse
c. Temperature
d. Respirations

 

 

  1. The client has been diagnosed with Alzheimer’s disease and needs to be started on an acetylcholinesterase inhibitor drug. He has preexisting liver disease. The nurse anticipates the he will most likely be ordered which drug?
a. Aricept
b. Hydergine
c. Exelon
d. Cognex

 

 

 

MULTIPLE RESPONSE

 

  1. A client is ordered to receive an anticholinergic to control the symptoms of Parkinson’s disease. The nurse is teaching the client precautions about the medication class. What would be included in the treatment plan? (Select all that apply.)
a. Use sunglasses to deal with photophobia.
b. Drooling is a common side effect.
c. Have routine eye examinations.
d. Void before taking the medication.
e. Anticholinergics have few interactions with other medications.
f. Ensure adequate fiber in the diet.

 

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 24: Drugs for Neuromuscular Disorders: Myasthenia Gravis, Multiple Sclerosis, and Muscle Spasms

 

Test Bank

 

MULTIPLE CHOICE

 

  1. The client has been ordered to be treated with Edrophonium (Tension). The client who is most likely to be ordered this drug is the one who is suspected of having:
a. multiple sclerosis.
b. seizure disorders.
c. parkinsonism.
d. myasthenia gravis (MG).

 

 

 

  1. A nurse is teaching a client who has been prescribed carisoprodol (Soma) for treatment of acute skeletal muscle spasms. Which instruction will the nurse include in the client’s teaching plan?
a. Take carisoprodol 1 hour before meals.
b. Discontinue taking carisoprodol if experiencing drowsiness.
c. Report episodes of rapid heart rate.
d. Carisoprodol is usually taken for no longer than 7 days.

 

 

 

  1. A client with myasthenia gravis and his family are receiving instructions from the nurse. The nurse teaches the client that insufficient dosing of cholinesterase inhibitor may result in myasthenia crisis. The client is taught about which signs and symptoms of myasthenia crisis?
a. Decreased muscle strength in the lower extremities
b. Increased salivation and sweating
c. Muscle weakness and increased salivation
d. Muscle weakness; difficulty in breathing and swallowing

 

 

 

  1. As part of a teaching session, a client with myasthenia gravis and her family are receiving instructions from the nurse. The nurse teaches the client that overdosing of cholinesterase inhibitor may result in cholinergic crisis. The client is taught about which signs and symptoms of cholinergic crisis?
a. Decreased muscle strength and decreased salivation
b. Increased salivation and sweating
c. Muscle weakness and increased salivation
d. Muscle spasticity and decreased salivation

 

 

 

  1. A nurse is aware that when treating a client with cholinesterase inhibitors, it is imperative to have the antidote at the bedside. The nurse anticipates that the client will be ordered:
a. epinephrine.
b. norepinephrine.
c. atropine.
d. edrophonium chloride (Tensilon).

 

 

 

  1. The client is suspected of having multiple sclerosis. Which diagnostic test is the client most likely to be ordered?
a. Computed tomography scan
b. Magnetic resonance imaging (MRI)
c. Protein in the cerebrospinal fluid
d. Angiography

 

 

 

  1. A client is being evaluated for multiple sclerosis. The nurse may observe which symptoms of multiple sclerosis?
a. Diplopia and weakness of the extremities
b. Rigidity and tremors
c. Masked facies and pill-rolling motion of the hand
d. Memory loss and inability to concentrate

 

 

 

  1. A client is diagnosed with multiple sclerosis and is to receive home care. The home care nurse is aware that some drugs are contraindicated with this disease, including:
a. histamine2 blockers.
b. calcium channel blockers.
c. adrenocorticotropic hormone (ACTH).
d. glucocorticoids.

 

 

 

  1. A client is admitted to a nursing unit with an acute exacerbation of multiple sclerosis (MS). What drug, frequently used to decrease the inflammatory response, is used during an acute MS attack?
a. Nonsteroidal antiinflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin, others)
b. Adrenocorticotropic hormone (ACTH)
c. Biologic response modifiers, such as interferon beta-1b (Betaseron)
d. Immunosuppressants, such as cyclophosphamide (Cytoxan)

 

 

 

  1. The client is prescribed Flexeril to relieve muscle spasms. The most important instruction that the nurse can give the client is to take the medication:
a. on an empty stomach.
b. with food or milk.
c. upon arising.
d. with water only.

 

 

 

  1. A client with chronic and progressive multiple sclerosis is ordered to receive cyclophosphamide (Cytoxan) to decrease symptoms. Based on this class of drug, which nursing diagnosis is a priority during this treatment?
a. Risk for injury owing to seizure activity
b. Risk for infection owing to immunosuppression
c. Risk for constipation owing to neurotoxicity
d. Risk for deficient fluid volume owing to diuresis

 

 

 

  1. A child with cerebral palsy and spasticity is being treated with baclofen (Lioresal). Because drowsiness is a side effect, the nurse plans to administer the medication:
a. during meals.
b. a half-hour before physical therapy.
c. during morning care.
d. at bedtime.

 

 

 

  1. A client with myasthenia gravis is noted to be salivating, tearing, and sweating. The client complains of muscle weakness. What would the nurse anticipate administering?
a. Pyridostigmine bromide
b. Neostigmine
c. Edrophonium
d. Atropine sulfate

 

 

 

  1. A client is ordered to receive carisoprodol (Soma) for muscle relaxation. The client takes the medication for 3 weeks and then abruptly stops. The client is at increased risk for:
a. excessive muscle relaxation.
b. decreased range of motion.
c. increased inflammation.
d. rebound muscle spasms.

 

 

 

  1. A client is ordered to receive adrenocorticotropic hormone (ACTH) for multiple sclerosis. Which nursing intervention would be most appropriate to protect this client from the side effects of this medication?
a. Implement infection control measures.
b. Administer antiemetics as needed.
c. Give laxatives daily and as needed.
d. Administer acetaminophen q4h.

 

 

 

  1. A client with myasthenia gravis demonstrates diplopia, ptosis, and dysphagia. The client is ordered to receive pyridostigmine bromide (Mestinon). What would indicate a positive outcome?
a. Increase in the ability to sleep
b. Decrease in muscle weakness
c. Increase in hemiparesis
d. Decrease in metabolic rate

 

 

 

  1. The client has been ordered to be treated with Robaxin. The client calls the nurse in a panic and reports that his urine is black in color. The nurse’s response should be based on the knowledge that this is indicative of a(n) _______ to the medication.
a. anaphylactic reaction
b. adverse reaction
c. subnormal response
d. expected response

 

 

 

  1. The nurse receives report on a client with multiple sclerosis who is scheduled to be treated with Cytoxan. The nurse anticipates that the client will be:
a. wheelchair enabled.
b. experiencing motor weakness.
c. complaining of fatigue.
d. diagnosed with optic neuritis.

 

 

 

  1. The nurse recognizes that a dose of an AChE inhibitor was given 1 hour late. The nurse anticipates that the client will exhibit which symptom as a result of the late dosage?
a. Excessive salivation
b. Difficulty breathing
c. Muscle weakness
d. Bradycardia

 

 

MULTIPLE RESPONSE

 

  1. A client with myasthenia gravis is experiencing a myasthenic crisis. Which symptoms are associated with myasthenia gravis? (Select all that apply.)
a. Weakness
b. Fatigue
c. Vomiting
d. Sweating
e. Drooling
f. Tearing

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 25: Antiinflammatory Drugs

 

Test Bank

 

MULTIPLE CHOICE

 

  1. A client is ordered to receive an NSAID for a disorder. The client states that she is aware that NSAIDs are frequently taken to decrease inflammation. The nurse clarifies that these agents may also be taken to:
a. decrease pulse rate.
b. reduce body temperature.
c. decrease blood pressure.
d. increase platelet aggregation.

 

 

 

  1. A nurse is teaching a client who has been prescribed NSAIDs for osteoarthritis. The nurse instructs the client that the best time to take the medication will be:
a. upon rising.
b. with meals.
c. on an empty stomach.
d. at bedtime.

 

 

 

  1. A client is ordered to receive aspirin after an acute heart attack. The nurse is evaluating use of this medication with other medications. The nurse is aware that aspirin can cause which drug interaction?
a. Increased risk of bleeding with anticoagulants
b. Decreased risk of hypoglycemia with oral hypoglycemic drugs
c. Decreased ulcerogenic effect with glucocorticoids
d. Increased risk of infection with amoxicillin

 

 

 

  1. A group of clients cared for by the nurse is ordered to take NSAIDs. Which client instruction would the nurse question?
a. Instruct the client not to take aspirin and other NSAIDs together.
b. Instruct the client to take NSAIDs with meals or 8 ounces of fluid.
c. Instruct women to take NSAIDs during heavy menstrual flow for pain.
d. Instruct the client to avoid alcohol when taking NSAIDs.

 

 

 

  1. Clients with which disorders are most often responsive to the NSAID groups of medications?
a. Rheumatoid arthritis and osteoarthritis
b. Postoperative pain and discomfort
c. Infections and incisional pain
d. Gastrointestinal discomfort and bleeding

 

 

 

  1. A client is ordered to receive gold therapy. The client asks how long it will take for him to feel the effects of this medication. The nurse teaches the client that gold medications:
a. achieve the desired effect in 1 to 2 months.
b. achieve the desired effect in 3 to 4 months.
c. alleviate symptoms immediately.
d. are effective within 7 days of therapy.

 

 

 

  1. A client is receiving auranofin (Ridaura). Which instruction takes priority?
a. “You may have a salty taste in your mouth.”
b. “You may experience constipation.”
c. “You may experience visual changes.”
d. “You’ll need frequent blood counts drawn.”

 

 

 

  1. Client teaching related to colchicine (Novocolchine) includes which instruction?
a. “Take the drug on an empty stomach.”
b. “Keep fluid intake to no more than 1000 mL daily.”
c. “Take a laxative daily to prevent constipation.”
d. “Take the drug with food.”

 

 

  1. A client with rheumatoid arthritis is ordered to receive tumor necrosis factor (TNF) as treatment for symptoms. Which manifestations are of most concern to the nurse?
a. Elevated temperature and a sore throat
b. Decreased range of motion and crepitation
c. Constipation and abdominal pain
d. Poor skin turgor and increased urine specific gravity

 

 

 

  1. Indomethacin (Indocin) is highly protein bound and is ordered as a new medication for the client. The client is taking another medication that is moderately protein bound. Upon administration of both medications, the nurse should be most concerned with:
a. indomethacin toxicity.
b. indomethacin levels below the therapeutic level.
c. an increase in medication side effects.
d. toxic levels of the first drug.

 

 

 

  1. In teaching a client about NSAIDs, the nurse is careful to teach about how to monitor for side effects. What side effect is of special concern?
a. Tachycardia
b. Polyuria
c. Elevated temperature
d. Gastrointestinal upset or distress

 

 

 

  1. A client diagnosed with acute gout is prescribed allopurinol (Zyloprim). The nurse is reviewing the client’s medication history and will contact the healthcare provider if the client is taking:
a. diphenhydramine (Benadryl).
b. metoclopramide (Reglan).
c. propranolol (Inderal).
d. warfarin (Coumadin).

 

 

 

  1. A client is ordered to receive celecoxib (Celebrex) for chronic pain caused by osteoarthritis. The nurse anticipates that the client will exhibit:
a. an increase in pain level.
b. an increase in bleeding time.
c. erosion of the stomach lining.
d. a decrease in inflammation.

 

 

 

  1. A client is ordered to receive a medication to relieve inflammation. The nurse determines that the medication is needed quickly. The nurse anticipates that which drug form will be ordered so that the medication can be released rapidly?
a. Tablet
b. Enteric-coated pill
c. Capsule
d. Liquid suspension

 

 

 

  1. A client is ordered to receive an NSAID for osteoarthritis. Which nursing intervention will treat the side effect most commonly associated with the NSAIDs?
a. Taking the medication with meals
b. Using sunscreen
c. Avoiding crowds
d. Encouraging deep breathing

 

 

 

  1. The client has been ordered to be treated with Benemid. What is the highest priority instruction to give the client?
a. “Take on an empty stomach.”
b. “Increase fluid intake.”
c. “Take with food.”
d. “Limit fluid intake.”

 

 

 

  1. The client has been ordered to be treated with Ridaura. The nurse anticipates seeing an increased _____ in the client’s laboratory results.
a. fasting blood glucose
b. liver enzyme tests
c. potassium level
d. calcium level

 

 

 

  1. The client is an older adult who has been diagnosed with cardiac arrhythmias. She has been ordered to be treated with Remicade. What should the nurse do?
a. Administer the medication as ordered by the physician.
b. Administer the drug after clarifying the dose with the pharmacist.
c. Hold the drug and conduct the physician; the dosage should be decreased.
d. Hold the drug and contact the physician; the drug is contraindicated.

 

 

 

  1. The client has been ordered to be treated with allopurinol. He complains to the nurse that he has noted changes in his vision. What is the most appropriate nursing intervention?
a. Explain to the client that this is an expected response to the drug.
b. Call the physician; this is a life-threatening response to the drug.
c. Explain to the client that this is a normal side effect of the drug.
d. Call the physician; this is an adverse reaction to the drug.

 

 

 

MULTIPLE RESPONSE

 

  1. A nurse is working on a pediatric unit. Which clients on the unit will be candidates for treatment with aspirin? (Select all that apply.)
a. Child who is experiencing pain from an injury
b. Child who has influenza-like symptoms
c. Child who is exhibiting fever
d. Child who has inflammation from an injury

 

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 26: Nonopioid and Opioid Analgesics

 

Test Bank

 

MULTIPLE CHOICE

 

  1. A client is ordered to receive a nonopioid analgesic. The nurse knows that the client is experiencing _____ pain.
a. acute severe
b. visceral (deep)
c. acute mild
d. superficial moderate to severe

 

 

  1. The client is complaining of severe pain. The nurse anticipates that the client will be ordered treatment with:
a. aspirin.
b. acetaminophen.
c. diflunisal.
d. morphine sulfate.

 

 

  1. A 5-year-old client has an elevated temperature as a result of a viral respiratory tract infection. What nonopioid drug should be given to decrease the child’s body temperature?
a. Aspirin
b. Acetaminophen
c. Diflunisal
d. Sodium salicylate

 

 

  1. An adolescent client tells the nurse that she takes acetaminophen (Tylenol) a few times every day because of “stress headaches.” The nurse advises her to see a primary healthcare provider because overuse of the medication may result in:
a. nausea and anorexia.
b. gastrointestinal irritation.
c. hepatotoxicity.
d. diaphoresis and fluid loss.

 

 

  1. A client takes aspirin regularly to deal with the pain of arthritis. Which symptom may be indicative of a serious side effect of the medication?
a. Intense abdominal pain
b. Frequent constipation
c. Excessive perspiration
d. Excessive fatigue

 

 

  1. A client is ordered to receive ibuprofen (Motrin) for dysmenorrhea. The highest priority instruction that the nurse should give the client is to take the drug:
a. with fluid or food.
b. on an empty stomach.
c. upon arising.
d. nightly before sleep.

 

 

  1. A client is prescribed morphine sulfate for management of severe pain. The client tells the nurse that he takes several herbal preparations. Which herbal preparation will be of most concern to the nurse?
a. Garlic
b. Ginger
c. St. John’s wort
d. Saw palmetto

 

 

  1. A nurse is planning the care of a client receiving opioid analgesia. What is considered a priority in planning this care?
a. Monitoring respiratory rate
b. Listening for adventitious breath sounds
c. Assessing for speed of pupillary reaction
d. Increasing the IV fluid flow rate

 

 

 

 

  1. A client requires an opioid antagonist after receiving an overdose of an opioid agent. The nurse anticipates that the client will be ordered:
a. pentazocine.
b. ibuprofen.
c. naloxone.
d. probenecid.

 

 

  1. The client is ordered methadone. The client is most likely experiencing:
a. opioid overdose.
b. acute or chronic pain.
c. opioid addiction.
d. sleep apnea.

 

 

  1. A nurse is assessing a postoperative client who received morphine sulfate for severe pain 1 hour ago. What common side effects are associated with this medication?
a. Constipation and pruritus
b. Diarrhea and lethargy
c. Tachycardia and hypertension
d. Coughing and wheezing

 

 

  1. A patient receives nalbuphine (Nubain) for intense pain related to a fracture. Which nursing intervention is an important part of the plan of care 1 hour after administration of this medication?
a. Strain all urine.
b. Elevate the head of the bed.
c. Monitor vital signs when getting out of bed.
d. Infuse IV fluid at a rapid rate.

 

 

  1. An adult client with a head injury complains of severe pain. The nurse notes that the dose of opioid is half the normal adult dose. What is the reason for this?
a. Head injury patients do not experience severe pain but are disoriented.
b. Respiratory depression can lead to cerebral hemorrhage.
c. Opioids decrease heart rate such that the brain becomes hypoxic.
d. Respiratory depression allows for a buildup of CO2, a vasodilator.

 

 

  1. A client receives hydromorphone (Dilaudid) following an operative procedure. The nurse assesses the client’s urine output in order to monitor for which side effect of this medication?
a. Urinary tract infections
b. Incontinence
c. Urinary retention
d. Renal failure

 

 

  1. An adult client has just received morphine sulfate for severe pain. What would indicate that the pain medication was effective?
a. Client lies very still in bed
b. Reduction of the respiratory rate to 8 breaths per minute
c. Facial grimacing and verbalization of relief of pain
d. Lowering of tachycardia to within normal limits

 

 

  1. The client is prescribed Imitrex for migraine headaches. She is nauseated and cannot take the medication by mouth. The nurse anticipates that the client will receive the medication via:
a. subcutaneous injection.
b. intramuscular injection.
c. intravenous infusion.
d. sublingual route.

 

 

  1. The client receiving Imitrex complains of dizziness. The nurse’s highest priority intervention is to recognize that this is a(n) ________ and notify the physician.
a. adverse reaction to the medication
b. food-drug interaction
c. side effect of the medication
d. life-threatening reaction to the drug

 

 

  1. The client is ordered Nubain intravenously for treatment of severe pain. The client anxiously asks when she can expect to have relief from the pain. The nurse anticipates that the client will have relief within _____ minutes.
a. 2 to 3
b. 5 to 6
c. 10 to 11
d. 15 to 16

 

 

  1. The client is taking acetaminophen on a regular basis as well as oral contraceptives. The nurse tells the client that this drug interaction will result in a(n) _____ in the effectiveness of the _____.
a. decrease; oral contraceptives
b. increase; oral contraceptives
c. decrease; acetaminophen
d. increase; acetaminophen

 

 

MULTIPLE RESPONSE

 

  1. A nurse has administered 8.0 mg morphine sulfate to an adult client in severe pain. What would the nurse evaluate as positive outcomes of this intervention? (Select all that apply.)
a. Respiratory rate of 6 breaths/min
b. Heart rate of 80 beats/minute
c. Blood pressure 180/110 mm Hg
d. Restlessness
e. Absence of facial grimacing
f. Verbalization of pain relief
g. Ability to take deep breaths

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 27: Antipsychotics and Anxiolytics

 

Test Bank

 

              MULTIPLE CHOICE

 

  1. A client is to receive a dose of fluphenazine hydrochloride (Prolixin) by intramuscular injection. What is the most important nursing intervention related to the injection?
a. Massage the site vigorously after injection.
b. Administer the drug using Z-tracking.
c. Avoid rotating the injection sites.
d. Select a 22- to 23-gauge needle.

 

 

 

  1. The client has been diagnosed with schizophrenia and is exhibiting a loss of function and motivation. The nurse recognizes that these symptoms are categorized as:
a. positive.
b. paranoiac.
c. negative.
d. incoherent.

 

 

 

  1. What is a common side effect for which the nurse must monitor during administration of both phenothiazine and non-phenothiazine medications?
a. Hypertension
b. Renal failure
c. Increase in number of white blood cells
d. Extrapyramidal symptoms

 

 

 

  1. A client is to be treated with Prolixin. The highest priority nursing intervention related to the client’s vital signs is to monitor for:
a. bradycardia.
b. hypertension.
c. hypotension.
d. tachypnea.

 

 

 

  1. A client has been taking a phenothiazine for 1 week. She contacts the crisis intervention clinic because she is still having symptoms. The nurse’s response is based on the premise that the desired effects usually take _____ to manifest.
a. 1 week
b. 1 to 3 weeks
c. 3 to 6 weeks
d. 3 to 5 months

 

 

 

  1. Extrapyramidal symptoms are a side effect of perphenazine (Trilafon). The nurse should assess and observe for which sign of akathisia?
a. Restlessness and constant moving about
b. Facial grimacing
c. Chewing motion
d. Involuntary eye movement

 

 

 

  1. Client teaching is important when antipsychotics are taken after discharge from the hospital. Nursing instruction should include giving which information to the client and family?
a. Therapeutic effect should occur in 2 to 3 days with maximum effect in 1 week.
b. The drugs should not be discontinued without consulting a healthcare provider.
c. Taking barbiturates in small dosages with the drug is usually permissible.
d. Rapid change in position has little effect on dizziness or blood pressure.

 

 

 

  1. A client is ordered to receive chlordiazepoxide (Librium) for severe anxiety. The nurse monitors for which symptoms of severe anxiety or panic attack?
a. Dyspnea and heart palpitations
b. Trembling, shaking, and gastrointestinal upset
c. Dizziness and anorexia
d. Drowsiness and blurred vision

 

 

 

  1. A client is experiencing severe EPS effects. In addition to administering a lower dose of the antipsychotic agents, the nurse would anticipate administering a medication in which category?
a. Cholinergics
b. Anticholinergics
c. Antidepressants
d. Dopamine agonists

 

 

 

  1. A client is taking an anxiolytic agent secondary to grief-related anxiety. The client questions the nurse about abruptly discontinuing these agents. The nurse’s response is based on the knowledge that, when discontinuing these medications:
a. the dosage must be tapered to avoid withdrawal.
b. the client must be evaluated for hyperglycemia.
c. hangover syndrome must be planned for.
d. blood levels must be monitored.

 

 

 

  1. A client is ordered to receive diazepam (Valium). The nurse is teaching the client about her medication. Which information would be included in the teaching plan?
a. The medication causes high levels of energy and activity.
b. The medication is effective in aiding clients with suicidal ideations.
c. The medication may be taken concurrently with other benzodiazepines.
d. The client may develop tolerance after prolonged use.

 

 

 

  1. A client is brought to the emergency department unconscious. The client’s spouse tells the nurse that the client was found in bed with an empty pill bottle nearby. The client’s spouse believes that there were 20 to 25 diazepam (Valium) pills in the bottle. What represents an appropriate nursing priority?
a. Administer an emetic agent followed by activated charcoal.
b. Lavage the stomach using a nasogastric tube.
c. Prepare the client for emergency surgery.
d. Monitor the client because there is no antidote.

 

 

 

  1. A client is ordered to receive fluphenazine (Prolixin) to manage the psychotic symptoms of schizophrenia. The nurse assesses for which signs of anticholinergic effects?
a. Bradycardia and orthostatic hypotension
b. Diarrhea and tachycardia
c. Urinary retention and dry mouth
d. Constipation and hypertension

 

 

 

  1. A client is receiving an antipsychotic agent. Which laboratory result is of most concern?
a. Serum sodium level of 138 mEq/L
b. Blood glucose level of 100 mg/dl
c. White blood cell count of 6000/mm3
d. Serum medication level below normal limits

 

 

 

  1. The client has been placed on Ativan. The nurse is planning a client instructional session. Which herbal preparation should the nurse emphasize that the client avoid taking with Ativan?
a. Kava kava
b. St. John’s wort
c. Ginseng
d. Ginger

 

 

 

  1. The client has been placed on Risperdal. He complains to the nurse of experiencing headaches. The highest priority action on the part of the nurse is to recognize that this is a(n) ________ the medication and call the physician.
a. adverse reaction to
b. expected side effect of
c. life-threatening reaction to
d. anaphylactic reaction to

 

 

 

  1. The client is an older adult who has been placed on Librium. The nurse recognizes that the dose of the drug _____ for this client.
a. is contraindicated
b. should be increased
c. should be decreased
d. will not change

 

 

 

  1. The nurse is preparing a dose of Mellaril. What is the highest priority intervention for the nurse while preparing the dose?
a. Draw up the dosage of the liquid in an oral syringe.
b. Use a 21-gauge needle to administer the injection.
c. Start a new IV site before administering the drug.
d. Avoid spilling the liquid on exposed skin.

 

 

 

  1. The client is known to have overdosed on a benzodiazepine medication. The nurse anticipates that which medication will most likely be ordered?
a. Tranxene
b. Romazicon
c. BuSpar
d. Librium

 

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 28: Antidepressants and Mood Stabilizers

 

Test Bank

 

MULTIPLE CHOICE

 

  1. A nurse is scheduling a client’s medications. The client is ordered to receive a daily dose of fluoxetine (Prozac). Because of the major side effects of this medication, the nurse correctly scheduled this medication at:
a. 0800.
b. 1200.
c. 1700.
d. 2200.

 

 

 

  1. A client is ordered a tricyclic antidepressant. In monitoring this client, the nurse would assess for:
a. orthostatic hypotension.
b. secondary hypertension.
c. gastrointestinal upset.
d. bradycardia.

 

 

 

  1. A client is ordered fluoxetine (Prozac) for mild depression. The nurse would monitor for which side effect(s)?
a. Dry mouth and eyes
b. Extrapyramidal syndrome
c. Leukopenia (decrease in WBCs)
d. Nervousness, restlessness, and insomnia

 

 

 

  1. A nurse works in an assisted living setting. The nurse is administering a selective serotonin reuptake inhibitor to an 84-year-old client. The nurse is aware that the daily dose of this medication for the older adult client would be _____ the adult dose.
a. the same as
b. higher than
c. about half
d. about one-fourth

 

 

 

  1. Which beverage will the nurse instruct a client taking lithium (Eskalith) for treatment of bipolar disorder to avoid?
a. Cola
b. Grape juice
c. Milk
d. Orange juice

 

 

 

  1. Serum lithium level is important to monitor because it has a narrow therapeutic range. What is the reference (therapeutic) range?
a. 0.5 to 1 mEq/L
b. 0.5 to 1.5 mEq/L
c. 1.5 to 3 mEq/L
d. 2 to 2.5 mEq/L

 

 

 

  1. A client is receiving lithium (Eskalith). Which serum electrolyte level is of greatest concern to the nurse?
a. Calcium level of 4.5 mEq/L
b. Potassium level of 3 mEq/L
c. Sodium level of 130 mEq/L
d. Potassium level of 5.7 mEq/L

 

 

 

  1. A nurse is scheduling a client’s medications. The client is ordered to receive a daily dose of amitriptyline (Elavil). Because of the major side effects of this medication, the nurse correctly schedules this medication at:
a. 8:00 AM.
b. 12:00 PM.
c. 5:00 PM.
d. 10:00 PM.

 

 

 

  1. A client is on maintenance lithium therapy for bipolar disorder. The client enters the emergency department complaining of tremors. The client appears to be giddy and confused. A serum lithium level is drawn and is found to be 2 mEq/L. The nurse would anticipate:
a. holding the next dose of lithium.
b. administering the next dose of lithium at the next scheduled time.
c. administering the next dose of lithium STAT.
d. administering a dose of lithium double the normal dose.

 

 

 

  1. A client begins taking paroxetine (Paxil) for obsessive-compulsive disorder. Which client statement would indicate that the medication is effective?
a. “I have so much energy now, I don’t need sleep.”
b. “I stayed up all last night cleaning my house.”
c. “I am learning to set priorities for what has to be done.”
d. “I do not go out much because of the germs.”

 

 

 

  1. The client has been treated with antidepressants for mild depression for 3 years. The client says her medication is no longer working, and she states that she has heard that MAO inhibitors are effective medications in treating depression. The nurse would respond based on the knowledge that:
a. there are few side effects with this medication.
b. this medication requires significant dietary restrictions.
c. this medication is relatively ineffective for depression.
d. this medication causes hypertensive crisis.

 

 

 

  1. Which intervention is highest priority for the care plan of a client on lithium therapy?
a. Drink 1 to 2 L of water per day.
b. Limit caffeinated beverages.
c. Eat three meals daily.
d. Suck on ice chips for dry mouth.

 

 

 

  1. A client is taking an antidepressant. What would indicate a side effect of anticholinergic origin?
a. Diarrhea
b. Increased salivation and drooling
c. Urinary retention
d. Bradycardia

 

 

 

  1. A client is taking fluoxetine (Prozac) for mild depressive disorder. The nurse is providing teaching and counseling. The client complains of lack of sexual desire and diminished sexual arousal. The nurse’s response is based on the fact that:
a. this is a known side effect and may require intervention.
b. this side effect will go away in 1 to 2 weeks.
c. this is a side effect of depression, not of medication.
d. clients may stop the medication on days they want to have sex.

 

 

 

  1. The client is on medication for hypertension as well as a monamine oxidase inhibitor. The highest priority instruction that the nurse should give to the client regarding supplements or herbal preparations is to avoid:
a. food with brewer’s yeast.
b. food containing garlic.
c. ginger supplements.
d. feverfew supplements.

 

 

 

  1. The client is a 10 year old who is being considered for lithium therapy. What should the nurse recognize as a priority in this decision?
a. The normal adult dosage should be halved for this client.
b. Lithium is contraindicated for a client this age.
c. The standard dosage of lithium can be administered.
d. The pediatric dosage must be clarified with the pharmacist.

 

 

 

  1. The client is due to be started on Prozac. What changes in the client’s bodily functioning should the nurse anticipate?
a. Daytime drowsiness
b. Increased sodium level
c. ECG changes
d. Thyroid dysfunction

 

 

 

  1. The client has been started on Elavil. He tells the nurse that he does not take any other medication except for St. John’s wort, which he has found to be mildly therapeutic. What should be the nurse’s highest priority response to this information?
a. The combination of Elavil and St. John’s wort can be particularly therapeutic.
b. Use of St. John’s wort can cause the dosage of Elavil to require increase.
c. Use of St. John’s wort can cause the Elavil to be completely ineffective.
d. The combination of St. John’s wort and Elavil can produce serotonin syndrome.

 

 

  1. The client is being treated with lithium regularly. The best time for blood to be drawn from the client to check her lithium level is _____ hours after the previous dose.
a. 4 to 8
b. 6 to 10
c. 8 to 12
d. 10 to 14

 

 

 

MULTIPLE RESPONSE

 

  1. A client is ordered to receive an MAO inhibitor in the treatment of major depression. Which foods and beverages will be restricted while the client is on this medication? (Select all that apply.)
a. Bread
b. Wine
c. Aged cheese
d. Meat
e. Citrus fruit
f. Coffee

 

 

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 29: Penicillins and Cephalosporins

 

Test Bank

 

MULTIPLE CHOICE

 

  1. A nurse is ordered to draw blood levels for a person receiving an antibiotic. The nurse is aware that peaks and troughs of serum antibiotic levels are monitored for drugs with a:
a. narrow therapeutic index.
b. large therapeutic index.
c. long half-life.
d. short half-life.

 

 

 

  1. A client’s medication warrants peak and trough levels to be drawn. The nurse is aware that if the peak level of the drug is too high, what could occur?
a. Mild side effects
b. Inadequate drug action
c. Slow onset of drug action
d. Drug toxicity

 

 

 

  1. Drug concentration is important for the eradication of bacterial infection. It is desired to keep the drug dose:
a. below minimum effective concentration.
b. above minimum effective concentration.
c. below minimum toxic level.
d. above minimum toxic level.

 

 

 

  1. With continuous use of antibiotics, antibiotic resistance result because:
a. bacteria are producing fewer mutations.
b. the immune system has enhanced ability to fight infection.
c. mutant bacteria are surviving antibiotic use.
d. fewer new antibiotics have been produced.

 

 

  1. A client with otitis media is ordered to receive amoxicillin (Amoxil). The client discloses to the nurse that she is allergic to penicillin. What is the highest priority action on the part of the nurse?
a. Notify the healthcare provider that the client is allergic to penicillin.
b. Encourage the client to take the dose under close monitoring.
c. Administer half of the amoxicillin dose under supervision.
d. Report the amoxicillin order to the supervisor.

 

 

 

  1. A client has relayed instructions from a physician regarding an allergy to a type of antibiotic therapy. The nurse would question which instruction?
a. Wear a Medic Alert bracelet that indicates the allergy.
b. Avoid all penicillin-type drugs.
c. Inform all healthcare providers of the allergy.
d. Restrict fluids when taking the antibiotic.

 

 

 

  1. When antibacterials are prescribed for the treatment of an infection and a culture is ordered, what should happen next?
a. The initial dose of the antibiotic should be given before the culture is taken.
b. The culture should be taken before the initial dose of the antibiotic is given.
c. The culture should be taken any time after the antibiotic therapy begins.
d. The culture may be taken at any time before or during antibiotic therapy.

 

 

 

  1. A client at an outpatient clinic is ordered to receive ampicillin (Omnipen) for an infection. Which nursing intervention related to penicillins would the nurse question?
a. Verify that the client is not allergic to penicillin.
b. Obtain culture before administering the first dose of medication.
c. Instruct client to discontinue penicillin when temperature is normal.
d. Encourage the client to increase fluid intake.

 

 

 

  1. Most beta-lactam antibiotics are excreted through the kidneys. The nurse should assess the client’s renal function by monitoring which levels?
a. Blood urea nitrogen and serum creatinine
b. Creatinine phosphokinase and alkaline phosphatase
c. White blood cell count and red blood cell count
d. Hemoglobin and hematocrit

 

 

 

  1. A client is ordered to receive a cephalosporin to treat a bacterial infection. Regarding monitoring of the client, the highest priority action on the part of the nurse includes assessing the client for which side effects?
a. Nausea, vomiting, and diarrhea
b. Photophobia and phototoxicity
c. Pain with urination and blood in the urine
d. High fevers and sweating

 

 

 

  1. A client has been receiving a cephalosporin for 20 days to treat a severe bacterial infection. The client complains of mouth pain, and the nurse assesses white patches in the client’s mouth. What is the highest priority action on the part of the nurse?
a. Provide mouth care with glycerin swabs.
b. Encourage the client to drink more fluids.
c. Notify the physician and describe symptoms.
d. Administer analgesia for the mouth pain.

 

 

 

  1. A client who reports an allergy to penicillin is ordered to receive cephalexin (Keflex). The correct action for the nurse is to:
a. administer the medication as ordered with additional fluids.
b. administer the medication and carefully observe for allergic reaction.
c. call the physician to change the order because of the allergy history.
d. administer another antibiotic after consulting the pharmacist.

 

 

 

  1. The client has been ordered treatment with Cefaclor as well as erythromycin. The nurse anticipates what effect from the interaction of the medications?
a. Increased action of the Cefaclor
b. Decreased action of the Cefaclor
c. Anaphylactic reaction to the Cefaclor
d. Toxic action of the Cefaclor

 

 

 

  1. The client has been ordered Cefazolin. The nurse anticipates an increase in the client’s _____ from this medication?
a. BUN and serum creatinine
b. serum potassium
c. serum calcium
d. serum white blood cells

 

 

 

  1. The client has been ordered to be treated with amoxicillin. The highest priority instruction that the nurse should give the client related to diet while on the medication is to avoid:
a. green leafy vegetables.
b. beef and other red meat.
c. coffee, tea, and colas.
d. acidic fruits and juices.

 

 

 

  1. The client has been ordered treatment with Wycillin. The nurse notes that the solution is milky in color. What is the highest priority action on the part of the nurse?
a. Call the pharmacist and report the milky color.
b. Add normal saline to dilute the medication.
c. Call the physician and report the milky appearance.
d. Administer the medication as ordered by the physician.

 

 

 

  1. The client has been ordered treatment with Amoxil. The client reports to the nurse that she has developed symptoms of vaginitis. The highest priority action on the part of the nurse is to recognize this as:
a. an expected side effect of the medication.
b. a life-threatening reaction to the drug.
c. evidence of development of a superinfection.
d. evidence of an anaphylactic reaction.

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 30: Macrolides, Tetracyclines, Aminoglycosides, and Fluoroquinolones

 

Test Bank

 

MULTIPLE CHOICE

 

  1. The client has a hypersensitivity to penicillin. The nurse anticipates that the drug of choice for this client will be:
a. cefuroxime (Ceftin, Zinacef).
b. clindamycin (Cleocin).
c. erythromycin (E-mycin, Ilotycin).
d. gentamicin SO4 (Garamycin).

 

 

 

  1. A client has a bacterial infection and is ordered to receive Zithromax. Based on its half-life, the nurse anticipates giving this drug _____ per day.
a. once
b. twice
c. three times
d. four times

 

 

 

  1. A client is to receive erythromycin intravenously. What is the highest priority nursing intervention?
a. Call the physician; the drug should not be given IV.
b. Administer the solution slowly to avoid pain.
c. Administer the solution quickly to prevent infection.
d. Call the pharmacist to verify the correct route.

 

 

 

  1. A client is taking a high dose of azithromycin (Zithromax). The client should be monitored for which adverse reaction?
a. Nephrotoxicity
b. Hepatotoxicity
c. Neurotoxicity
d. Blood dyscrasias

 

 

 

  1. The highest priority nursing intervention for the client receiving azithromycin (Zithromax) is to:
a. assess liver enzymes on a regular basis.
b. instruct the client to take the drug on an empty stomach.
c. administer a laxative daily to prevent constipation.
d. administer each dose of medication with antacids.

 

 

 

  1. A 7-year-old client is being evaluated for treatment with tetracycline. Which knowledge is most important for the nurse to share with the client and parents about tetracycline?
a. Tetracycline is safe if taken during pregnancy.
b. Tetracycline may cause permanent discoloration to the teeth if taken before age 8 years.
c. Tetracycline causes bone marrow suppression in clients of all ages.
d. Tetracycline should be taken with milk or milk products and antacids to avoid gastrointestinal side effects.

 

 

 

  1. The client is being treated with minocycline. The nurse anticipates what dosage schedule for the medication?
a. Coordinated with meals
b. Given once daily
c. Given on an empty stomach
d. Coordinated with bedtime

 

 

 

  1. A client is ordered to receive tetracycline. The client reports that she is using oral contraceptives. The nurse’s recommendations are based on the fact that when tetracycline is taken with an oral contraceptive, the desired action of the oral contraceptive is:
a. increased.
b. decreased.
c. affected in an unpredictable way.
d. nullified.

 

 

 

  1. The client will be prescribed Achromycin. The nurse anticipates that this medication will be given:
a. with each meal.
b. with extra water.
c. on an empty stomach.
d. one half-hour after meals.

 

 

 

  1. The client has been prescribed Garamycin. The highest priority nursing intervention related to a life-threatening side effect of the medication is to monitor for:
a. blood pressure changes.
b. decrease in pulse rate.
c. nausea and vomiting.
d. decreased urinary output.

 

 

 

  1. The client has been started on Garamycin. She complains to the nurse of changes in her level of hearing. What is the highest priority nursing intervention on the part of the nurse?
a. Restrict fluid intake.
b. Assess for paralytic ileus.
c. Hold the next dose of medication and notify the physician.
d. Monitor urine for sugar.

 

 

 

  1. A client who takes oral hypoglycemics for type 2 diabetes mellitus is diagnosed with a severe infection and is ordered to receive levofloxacin (Levaquin). Based on the interaction of the medications, the highest priority nursing intervention is to frequently assess:
a. complete blood count.
b. BUN and creatinine levels.
c. liver enzymes.
d. serum blood glucose level.

 

 

 

  1. A young child is diagnosed with meningitis and is prescribed an aminoglycoside. Based on the potentially toxic effects of the medication, what is the highest priority nursing intervention?
a. Schedule hearing tests and assess of urine output.
b. Assess urine output and bone marrow function.
c. Assess renal and hepatic function.
d. Assess visual acuity and color discrimination.

 

 

 

  1. A nurse is administering gentamicin (Garamycin) intravenously to a client. The drug is due to be administered at 2100. The nurse should anticipate that the peak level will be drawn at which time?
a. 2030
b. 2100
c. 2145
d. 2330

 

 

 

  1. The client has been ordered to be treated with tetracycline. He is also being treated with digoxin. The nurse anticipates that, based on the interaction of the two drugs, the client will experience _____ effects of the _____.
a. increased; digoxin
b. increased; tetracycline
c. decreased; digoxin
d. decreased; tetracycline

 

 

 

  1. The client has been ordered to be treated with Vibramycin. What effect should the nurse anticipate seeing in the client’s laboratory values?
a. Increased serum potassium
b. Decreased serum potassium
c. Increased serum calcium
d. Decreased serum calcium

 

 

 

  1. The client is scheduled to receive a dose of IV tetracycline at 9 PM. At what time should the nurse schedule her peak drug level to be drawn?
a. 9:15 PM
b. 9:45 PM
c. 11:00 PM
d. 11:45 PM

 

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 31: Sulfonamides

 

Test Bank

 

              MULTIPLE CHOICE

 

  1. A nurse is aware that crystalluria is a common problem with sulfonamides. What is a nursing intervention to prevent this problem?
a. Intravenous therapy
b. Giving the medication in the morning
c. Increasing intake of calcium
d. Increasing fluid intake

 

 

 

  1. A client with a UTI is ordered to receive trimethoprim-sulfamethoxazole, also known as co-trimoxazole (Bactrim, Septra). The nurse is aware that Bactrim is a combination of two drugs. What is the purpose of this combination?
a. It decreases the response against disease-producing organisms.
b. The two drugs have an antagonistic drug effect.
c. Trimethoprim prevents bacterial resistance to sulfamethoxazole.
d. It prevents toxic drug effects.

 

 

 

  1. Co-trimoxazole (Bactrim, Septra) has a half-life of 8 to 12 hours. Based on this information, the nurse decides to administer the drug at which time(s) each day?
a. 9:00 AM
b. 8:00 AM and 8:00 PM
c. 8:00 AM, 12:00 PM, 4:00 PM, and 8:00 PM
d. 8:00 AM, 12:00 PM, 4:00 PM, 8:00 PM, and 12:00 AM

 

 

 

  1. A client is ordered to receive co-trimoxazole (Bactrim, Septra). The nurse assesses for side effects. What causes the nurse the greatest concern?
a. Neutropenia and agranulocytosis
b. Nausea and vomiting
c. Headache and vertigo
d. Fatigue and anorexia

 

 

 

  1. A client with type 2 diabetes is treated with a sulfonylurea agent. The client is diagnosed with a urinary tract infection and is ordered to receive co-trimoxazole (Bactrim, Septra). The nurse should evaluate for a(n):
a. increased hyperglycemic response.
b. increased hypoglycemic response.
c. decreased action of the sulfonamide drug.
d. prolonged action of the sulfonamide drug.

 

 

 

  1. A client is ordered to take the anticoagulant warfarin (Coumadin) with co-trimoxazole (Bactrim, Septra). Based on the interaction of the drugs, the client’s warfarin level should be monitored and the dose may need to be adjusted in which way?
a. Increased
b. Decreased
c. Taken every other day
d. Discontinued

 

 

 

  1. A client is diagnosed with an infection and is ordered to receive a sulfonamide. What would the nurse evaluate as a positive response to the treatment?
a. Temperature within normal limits
b. A decrease in urine output
c. Increase in dysuria
d. A rising white blood cell count

 

 

 

  1. Which nursing instruction related to photosensitivity is highest priority for the client receiving a sulfonamide?
a. “Use a high SPF sunblock when out in the sun.”
b. “Avoid driving during daylight hours.”
c. “Take vitamin D to prevent photosensitivity.”
d. “Apply a moisturizer before going outside.”

 

 

 

  1. A client is diagnosed with a urinary tract infection and is ordered to receive 160 mg trimethoprim/200 mg sulfamethoxazole. Based on the physician’s order, what is the highest priority nursing intervention?
a. Call the pharmacist to clarify the order.
b. Call the physician to clarify the order.
c. Give the medication as ordered.
d. Hold the dosage to prevent anaphylaxis.

 

 

 

  1. The client has been ordered treatment with Gantanol. The highest priority instruction to provide this client is:
a. to take on an empty stomach.
b. to increase fluid intake to at least 2 L daily.
c. to take with meals.
d. it may produce bloody diarrhea.

 

 

 

  1. The client is being treated with one of the sulfonamides. She complains to the nurse of experiencing a sore throat. What is the highest priority action on the part of the nurse?
a. Administer the medication; this is an expected side effect of the medication.
b. Call the physician; this is symptomatic of development of a superinfection.
c. Call the physician; this is symptomatic of a life-threatening anemia.
d. Hold the medication and call the pharmacist for clarification.

 

 

 

  1. The client is being treated with Bactrim. The nurse should anticipate seeing an increase in the client’s serum:
a. glucose.
b. potassium.
c. BUN and creatinine.
d. calcium.

 

 

 

ESSAY

 

  1. A client is ordered to receive sulfisoxazole (Gantrisin) for chronic otitis media. The medication is ordered 5 mg/kg/dose. The client weighs 132 pounds. The medication is available as 125 mg/5 mL. The nurse should administer how many milliliters for each dose?

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 32: Antituberculars, Antifungals, Peptides, and Metronidazole

 

Test Bank

 

MULTIPLE CHOICE

 

  1. Which client would be highest priority to receive prophylactic antitubercular therapy?
a. Client who has been in close contact with a person having tuberculosis (TB)
b. Client with longstanding chronic liver disease
c. Healthcare professionals employed in health institutions
d. Family members of a client with TB, regardless of the type of contact

 

 

 

  1. The client asks the nurse why more than one drug is needed to treat his TB. The most accurate response from the nurse is that single-drug therapy to treat tuberculosis:
a. is effective with fewer side effects.
b. is ineffective because of possible drug resistance.
c. requires a short period to achieve effectiveness.
d. is useful for clients with many allergies.

 

 

 

  1. A client is diagnosed with tuberculosis. The nurse practitioner plans to treat the client’s family. The nurse anticipates that which drug will be ordered?
a. Streptomycin
b. Rifampin (Rifadin)
c. Isoniazid (INH)
d. Colistin

 

 

  1. A client asks the purpose for using isoniazid (INH) and rifampin (Rifadin) in combination to treat his tuberculosis. The nurse informs him that both agents are given:
a. to prevent side effects.
b. to prevent drug resistance.
c. to lengthen drug therapy.
d. for clients who are allergic to one of the antitubercular drugs.

 

 

  1. A client taking isoniazid (INH) complains of “pins and needles” in her fingertips. The nurse would recommend vitamin _____ to treat this neuropathy.
a. C
b. B6
c. D
d. B12

 

 

 

  1. The client is being treated with isoniazid (INH). The highest priority nursing intervention is to frequently monitor:
a. liver enzymes.
b. red blood cell count.
c. serum creatinine level.
d. blood urea nitrogen level.

 

 

 

  1. A client with tuberculosis is being monitored via periodic sputum testing. To obtain acid-fast bacilli, the nurse should plan to obtain the sputum specimen:
a. in the evening after dinner.
b. before sleep.
c. in the morning before breakfast.
d. before lunch and before the evening meal.

 

 

 

  1. A patient with a seizure disorder is exposed to a person with tuberculosis. The patient is taking phenytoin (Dilantin) and prophylactic isoniazid (INH). Based on the interaction of the medications, the nurse anticipates that the effect of phenytoin will be:
a. significantly increased.
b. significantly decreased.
c. slightly increased.
d. negated completely.

 

 

 

  1. The nurse notes that the client has been placed on amphotericin B (Fungizone). Based on the medication being used, the nurse recognizes that the client has been diagnosed with a _____ infection.
a. mild fungal
b. severe fungal
c. mild bacterial
d. severe bacterial

 

 

 

  1. A client is to receive amphotericin B (Fungizone). The nurse is planning care for the client based on the fact that this medication is administered via which route?
a. Oral
b. Intramuscular
c. Intravenous
d. Subcutaneous

 

 

 

  1. Which assessment is most important when a client begins to receive an infusion of Amphotericin B (Fungizone)?
a. Count apical heart rate for 1 full minute.
b. Assess blood pressure for hypotension.
c. Assess lower extremity motor function.
d. Determine a change in pulse pressure.

 

 

 

  1. Nystatin (Mycostatin), a polyene antifungal drug, is frequently administered as an oral suspension for Candida infection in the mouth. Client instruction regarding the administration of nystatin is to:
a. dilute the oral suspension with water and then swallow the solution.
b. drink the oral suspension and follow with 4 ounces of water.
c. drink the oral suspension but do not follow with fluid or food.
d. swish the liquid in the mouth and then swallow or expel the suspension.

 

 

 

  1. A client is to receive amphotericin B (Fungizone). Laboratory tests should be monitored when the client is receiving this potent antifungal drug. These tests include serum _____ levels.
a. calcium
b. potassium
c. albumin
d. glucose

 

 

 

  1. The highest priority nursing intervention while the client is being treated with polymyxin B (Aerosporin) is frequent monitoring of:
a. blood glucose and fasting blood glucose levels.
b. liver enzymes and liver function studies.
c. serum creatinine levels and urinary output.
d. hydration and serum albumin levels.

 

 

  1. A client is receiving IV caspofungin (Cancidas) for a severe Candida infection. During an infusion of the dose, the nurse notes a reddened area along the vein tract, and the client complains of pain. What is the highest priority nursing intervention?
a. Stop the infusion.
b. Speed up the infusion.
c. Administer an analgesic during the infusion.
d. Elevate the infusion extremity above the heart.

 

 

 

  1. The client has been diagnosed with candidiasis (thrush). The nurse anticipates that the client will be treated with:
a. co-trimoxazole.
b. pyrimethamine.
c. sulfamethoxazole.
d. fluconazole.

 

 

 

  1. A client is being treated with multidrug therapy for acute tuberculosis. The drug regimen includes streptomycin. What will be the highest priority nursing intervention while the client is being treated with streptomycin?
a. Assess urine output and kidney function.
b. Assess hearing acuity.
c. Monitor hepatic function.
d. Conduct an ECG to watch for changes.

 

 

 

  1. The client is being treated with rifapentine. The nurse plans to administer the medication every _____ hours.
a. 8
b. 16
c. 36
d. 72

 

 

 

  1. The client is being treated with ketoconazole. He tells the nurse that he frequently self-medicates with echinacea. The highest priority instruction that the nurse should give the client is that the combination of the two medications:
a. should enhance the action of the ketoconazole.
b. should diminish the action of the ketoconazole.
c. may result in hepatotoxicity developing.
d. may result in nephrotoxicity developing.

 

 

 

  1. The client is being treated with Metronidazole. She complains to the nurse of experiencing reddish brown urine. The nurse interprets this finding as a(n):
a. potentially life-threatening reaction to the medication.
b. symptom of an anaphylactic reaction to the medication.
c. sign that the medication dosage needs to be increased.
d. expected side effect of a high dose of the medication.

 

 

 

  1. The nurse is instructing the client on the proper way to self-administer nystatin. The client tells the nurse that he has been simply drinking a small amount of the medication from the bottle. The nurse explain to the client that the medication dosage should consist of 1 to 2:
a. teaspoons, swished and then swallowed.
b. teaspoons, swished and then expelled.
c. ounces, swallowed twice daily.
d. ounces, used to swab the oral cavity.

 

 

 

MULTIPLE RESPONSE

 

  1. A client is being treated for tuberculosis. Which medications are used to treat this condition? (Select all that apply.)
a. Streptomycin sulfate
b. Amoxicillin (Amoxil)
c. Ethambutol (Myambutol)
d. Gentamicin (Garamycin)
e. Rifabutin (Mycobutin)
f. Ethionamide (Trecator-SC)
g. Pyrazinamide

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 33: Antivirals, Antimalarials, and Anthelmintics

 

Test Bank

 

MULTIPLE CHOICE

 

  1. A client is diagnosed with the flu. The nurse is aware that in order to be effective, neuraminidase inhibitors should be taken within how many hours of onset of flu symptoms?
a. 24
b. 48
c. 72
d. 96

 

 

 

  1. A client is ordered to receive acyclovir (Zovirax). The nurse is aware that acyclovir is effective against various viruses and has a short half-life. The medication dose should be taken _____ day.
a. once a
b. twice a
c. three or more times a
d. once every other

 

 

 

  1. A nurse is monitoring for the side effects of acyclovir (Zovirax). The nurse anticipates that the client may experience what side effect?
a. Hepatotoxicity
b. High blood pressure
c. Increased intracranial pressure
d. Rash and pruritus

 

 

 

  1. The nurse assesses that the client is experiencing an adverse reaction to acyclovir (Zovirax) when the client exhibits which reaction?
a. Paralytic ileus
b. Liver failure
c. Leukopenia and thrombocytopenia
d. Gastric ulceration

 

 

  1. A nurse is providing discharge instructions to a client who is taking an antiviral agent. Client teaching associated with antiviral drug therapy includes:
a. reporting an increase in urine output.
b. maintaining adequate fluid intake.
c. decreasing sexual relations with or without the use of a condom.
d. reporting any side effects such as sexual dysfunction, dyspnea, and flushing.

 

 

 

  1. A nurse is providing instruction to a client who asked about ways to prevent drug-resistant malaria from occurring. The nurse should suggest:
a. the newest and most potent antimalarial drug.
b. a combination of antimalarial drugs.
c. the tetracycline group of antibiotics.
d. the antimalarial drug early after diagnosis of malaria.

 

 

 

  1. A nurse instructs a client that gastrointestinal (GI) upset is a common side effect of anthelmintics. To avoid GI distress, the client should take the anthelmintic:
a. between meals.
b. immediately after meals.
c. before breakfast and at bedtime.
d. before lunch without milk products.

 

 

 

  1. What is the highest priority nursing intervention for clients taking anthelmintics?
a. Instruct the client that daily stool specimens must be collected.
b. Inform the client that the pathogens are spread via blood.
c. Instruct the client to take baths and not showers.
d. Alert the client to avoid operating a car or machinery due to drowsiness.

 

 

 

  1. The client will need a prophylactic agent for herpes simplex. The nurse anticipates that the client will be ordered:
a. ciprofloxacin (Cipro).
b. fluconazole (Diflucan).
c. oral acyclovir (Zovirax).
d. pentazocine (Talwin).

 

 

 

  1. The client has been ordered treatment with Aralen. The nurse notes that the client’s blood pressure has decreased from 130/80 to 104/60. What is the nurse’s highest priority action?
a. Recognize that this is an expected side effect of the medication and monitor the client.
b. Call the physician; the client is experiencing an adverse reaction to the medication.
c. Recognize that this is a reaction to the dosage of the medication; call the pharmacist.
d. Call the physician; client is experiencing a life-threatening reaction to the medication.

 

 

 

  1. The client has been ordered treatment with Aralen. The nurse expect to see decreased _____ in the client.
a. serum glucose
b. potassium
c. hemoglobin and hematocrit
d. calcium

 

 

 

  1. The client has been ordered treatment with oral Zovirax at 9:00 AM. The nurse should expect the client’s serum level of the medication to peak at which time?
a. 10:45 AM
b. 12:30 PM
c. 9:30 AM
d. 2:00 PM

 

 

 

  1. The client has been ordered treatment with Zovirax. The nurse should expect to see increased _____ in the client’s laboratory levels.
a. liver enzymes
b. potassium
c. magnesium
d. blood urea nitrogen (BUN)

 

 

 

  1. The client has been ordered treatment with Denavir. The client should be instructed to apply the cream every:
a. 8 hours around the clock.
b. 2 hours during the day.
c. 4 hours around the clock.
d. 6 hours during the day.

 

 

 

  1. The client has been ordered treatment with Flumadine. The client has renal impairment. The nurse anticipates what change to the dose of medication?
a. Increased
b. Decreased
c. Unchanged
d. Held

 

 

 

  1. The client is being treated with an antiviral drug. He complains to the nurse of experiencing red, swollen gums. The highest priority action on the part of the nurse is to advise the client to:
a. perform oral hygiene several times daily.
b. rinse his mouth with hydrogen peroxide.
c. avoid using dental floss during hygiene.
d. rinse his mouth with alcohol-based mouthwash.

 

 

 

MULTIPLE RESPONSE

 

  1. A 5-year-old client is being treated for parasitic worms. What should be included in the client’s care? (Select all that apply.)
a. Take baths, not showers.
b. Wash hands frequently.
c. Change sheets daily.
d. Take medication until worms are no longer noted in the feces.
e. Be alert for drowsiness.
f. Watch for side effects of agitation.

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 34: Drugs for Urinary Tract Disorders

 

Test Bank

 

              MULTIPLE CHOICE

 

  1. The client has been ordered treatment with nitrofurantoin. She complains to the nurse of experiencing brownish, discolored urine. The nurse recognizes that this symptom indicates a(n) _____ the medication.
a. expected side effect of
b. adverse reaction to
c. life-threatening reaction to
d. anaphylactic reaction to

 

 

 

  1. The highest priority nursing intervention to enhance the absorption of nitrofurantoin) should be to take the drug:
a. between each meal.
b. 1 hour before meals and at bedtime.
c. with each meal.
d. either 1 hour before or 2 hours after meals.

 

 

 

  1. A client with a urinary tract infection is ordered to receive phenazopyridine hydrochloride (Pyridium) as a urinary analgesic. What information will client teaching include?
a. The medication has a high rate of adverse reactions.
b. Discolored urine is evidence of an anaphylactic reaction.
c. Side effects such as nausea, vomiting, and diarrhea must be reported.
d. The medication will prevent future urinary tract infections.

 

 

 

  1. A client has decreased bladder function and is ordered bethanechol (Urecholine). The nurse anticipates what expected outcome of the medication?
a. Stimulation of urination stimulate micturition
b. Decreased urinary tract spasms
c. Reduced urinary pain
d. Prevention of bacterial growth

 

 

 

  1. An older adult client with stress incontinence is ordered to receive tolterodine tartrate (Detrol). The nurse anticipates that treatment with this medication will result in:
a. decreased urination.
b. decreased urinary discomfort.
c. prevention of urinary tract infection.
d. control of an overactive bladder.

 

 

 

  1. A client presents to the emergency department with severe flank pain and foul-smelling urine. The urine culture is positive. Because of the symptoms, the nurse anticipates that the client has:
a. acute renal failure.
b. a lower urinary tract infection.
c. pyelonephritis.
d. acute cystitis.

 

 

 

  1. A client with a urinary tract infection is ordered to receive methenamine (Mandelamine). The nurse knows that this medication works best when the urine pH is less than 5.5. The nurse would recommend that the client:
a. maintain a low-residue diet.
b. take daily vitamin C.
c. eat a high-protein diet.
d. drink milk each day.

 

 

 

  1. A client has a urinary tract infection that is treated with an antibiotic. The medication has a tendency to cause crystalluria. Which nursing intervention may prevent this side effect?
a. Treating with urinary antispasmodics
b. Increasing oral fluid intake
c. Increasing intake of acid-ash fluids/foods
d. Maintaining urine specific gravity above 1.025

 

 

 

  1. Many of the urinary antiseptics work best with a specific urine pH. What are the optimal pH and a method to achieve this pH?
a. pH of 4.8, treatment with vitamin C
b. pH of 6.0, treatment with cranberry juice
c. pH of 6.1, treatment with milk
d. pH of 5.5, treatment with antacids

 

 

 

  1. The client has been ordered to be treated with nitrofurantoin. He is also being treated with probenecid. The nurse anticipates that the action of the two drugs will result in _____ the medication.
a. a decreased effect of
b. an increased effect of
c. no change in the usual effect of
d. an anaphylactic reaction to

 

 

 

  1. The client has been ordered treatment with Floxin. She complains to the nurse of insomnia. What does the nurse recognize about this symptom?
a. It is completely unrelated to the new medication.
b. It is indicative of an adverse reaction to the medication.
c. It shows that the client is achieving a toxic level.
d. It is an expected side effect of the medication.

 

 

 

  1. The client is being treated with methenamine. He has been self-medicating with sodium bicarbonate as an antacid. The nurse anticipates that the interaction of these two medications will result in a(n) ____ of methenamine.
a. enhanced action
b. inhibited action
c. toxic level
d. anaphylactic reaction

 

 

 

  1. The client is being treated with methenamine as well as with a sulfonamide. The nurse anticipates that the interaction of these two medications will result in an increased risk of:
a. pyelonephritis.
b. renal failure.
c. crystalluria.
d. renal calculi.

 

 

 

  1. The client is being treated with nitrofurantoin. How can the nurse determine that the drug has produced a positive outcome for the client when the client is free of _____ within 10 days.
a. blood in the urine
b. symptoms of UTI
c. evidence of renal calculi
d. flank pain

 

 

 

  1. Which client would be highest risk to develop acute pyelonephritis?
a. 42-year-old man
b. 2-year-old girl
c. 18-year-old man
d. 34-year-old woman

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 35: HIV- and AIDS-Related Drugs

 

Test Bank

 

MULTIPLE CHOICE

 

  1. A client with clinical AIDS is treated with a protease inhibitor. The highest priority nursing intervention based on this medication is to monitor for incidence of:
a. hepatic steatosis.
b. hyperglycemia.
c. urinary retention.
d. coma.

 

 

 

  1. A client with HIV is treated with the nonnucleoside reverse transcriptase inhibitor (NNRTI) efavirenz (Sustiva). The nurse is aware that other agents may be used because of which significant problem with NNRTIs?
a. Alopecia
b. Resistance
c. Coma
d. Hepatic dysfunction

 

 

 

  1. A client with a very low T4 count is placed on several medications to prevent infections. The nurse instructs the client to expect to be placed on which medication as a prophylactic agent to prevent herpes simplex?
a. Ciprofloxacin (Cipro)
b. Fluconazole (Diflucan)
c. Acyclovir (Zovirax)
d. Pentamidine (Nebupent)

 

 

 

  1. Which is important to consider when developing a plan with the client receiving antiretroviral therapy to ensure adherence to the therapeutic regimen?
a. Make no association between taking medications with daily routine.
b. Avoid discussing management of anticipated side effects.
c. Ensure client has understanding of the purpose for each drug.
d. Avoid confusing clients by telling them about drug actions.

 

 

 

  1. A child with AIDS is placed on antiretroviral therapy. The nurse’s instructions to the child and family are based on the premise that the goals of antiretroviral therapy include:
a. increasing viral load to detectable levels.
b. slowing the decline in the number of CD4 cells.
c. increasing resistance to opportunistic infections.
d. decreasing the severity of opportunistic infections.

 

 

 

  1. In teaching the client about Enfuvirtide (Fuzeon), the nurse would instruct the patient to watch for and report:
a. chronic diarrhea.
b. injection site irritation.
c. persistent arthralgia.
d. heart block.

 

 

 

  1. A client questions a nurse about taking antiretrovirals with other medications, which may cause drug interactions. What is the most accurate statement that the nurse can give in response?
a. “Make sure you do not take your antiviral medications with any other medications.”
b. “Bring all your medications into the office as soon as possible and we will ensure that they are safe to take together.”
c. “Next time you go to your doctor, let the doctor know all the medications you are taking.”
d. “If you have any questions about your medications, ask your pharmacist.”

 

 

 

 

  1. A nurse sustains a needlestick injury and is exposed to an HIV-positive patient’s blood. What is the highest priority action for the nurse?
a. Wait for appearance of symptoms to receive treatment.
b. Begin triple antibiotic therapy to prevent symptoms.
c. Start 4 weeks of antiretroviral therapy.
d. Start 10 days to 2 weeks of antibiotic therapy.

 

 

 

  1. A pregnant woman who is HIV positive may transfer the HIV virus to the fetus. The nurse caring for the client anticipates that the client will receive which medication to treat potential vertical transmission of HIV?
a. Acyclovir (Zovirax)
b. Zidovudine (AZT)
c. Isoniazid (INH)
d. Ethambutol (Myambutol)

 

 

 

  1. The client has been ordered to be treated with Kaletra. The nurse anticipates that the medication will be administered:
a. on an empty stomach.
b. with food.
c. at bedtime.
d. upon rising.

 

 

 

  1. The nurse anticipates the client’s laboratory values will result in increased ______ due to treatment with Kaletra?
a. cholesterol
b. magnesium
c. potassium
d. calcium

 

 

 

  1. The client has been started on treatment with Sustiva. To achieve maximum absorption of the drug, the client should choose a breakfast of:
a. whole-wheat toast with jam.
b. egg-white omelet with spinach.
c. sausage patties with an English muffin.
d. sliced fruit with nonfat yogurt.

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 36: Vaccines

 

Test Bank

 

MULTIPLE CHOICE

 

  1. A nurse is teaching a young pregnant woman about vaccines. Which statement is true about vaccines for pregnant women?
a. The varicella vaccine is contraindicated for pregnant women.
b. The rubella vaccine is allowed for pregnant women.
c. The pneumococcal vaccine is contraindicated only for women with asthma.
d. The influenza vaccine is contraindicated for pregnant women.

 

 

 

  1. The director of pharmacy for a medical facility is preparing to order pneumococcal vaccine. To determine the amount to order, she must decide which populations of clients served by the facility should receive the vaccine. She anticipates that the pneumococcal vaccine will be given to:
a. all children younger than 2 years.
b. only children older than 12 years.
c. only adults with chronic respiratory conditions.
d. only older adults who are nursing home residents.

 

 

 

 

  1. Vaccines may generally be administered in the presence of:
a. current antimicrobial therapy.
b. immunosuppression with neutropenia.
c. acute severe illness and fever.
d. previous allergic reactions to vaccines.

 

 

 

  1. A client is planning on traveling to tropical South America. The nurse counsels the client to pursue which vaccine?
a. Tetanus
b. Pertussis
c. Polio
d. Yellow fever

 

 

 

  1. A client is to receive a vaccine for measles. The vaccine includes antigens that, when added to the body, create an antibody response. This is an example of _____ immunity.
a. acquired active
b. acquired passive
c. natural active
d. natural passive

 

 

 

  1. The parent of a toddler consults the nurse regarding the most appropriate time to have the child immunized with the varicella vaccine. The child was hospitalized at age 14 months and required a blood transfusion. Based on the child’s age, the most appropriate time for the child to receive the varicella vaccine is at age _____ months.
a. 22
b. 25
c. 28
d. 30

 

 

 

  1. The client has received the varicella vaccine and now requires Ig. The client is 4 years and 10 months old. The most appropriate time for the client to receive Ig is at age:
a. 5 years.
b. 6 years.
c. 4 years 11 months.
d. 5 years 2 months.

 

 

 

  1. The client is an adult who has received the varicella vaccine. She has a history of arthritic-related discomfort. The most important instruction that the nurse can give this client is to avoid ________ after receiving the varicella vaccine.
a. alcohol for 1 month
b. dark green vegetables for 6 weeks
c. salicylates for 6 weeks
d. vitamin C for 1 month

 

 

 

  1. The client is scheduled to receive Gardasil. The vaccine would be most effective in the client who:
a. has produced a live viable birth.
b. has not yet produced children.
c. is sexually active on a regular basis.
d. is not yet sexually active.

 

 

 

  1. The client has received the first dose of Gardasil at age 15 years and 3 months. She safely can receive the second dose of the drug at 15 years, _____ months.
a. 6
b. 5
c. 4
d. 10

 

 

 

MULTIPLE RESPONSE

 

  1. An 8-year-old child enters the clinic. He has recently emigrated from another country and has received no immunizations. His parent does not believe that he has had chickenpox. Which immunizations should he receive at this visit? (Select all that apply.)
a. Pertussis
b. Tetanus
c. MMR
d. PPD
e. Hep B (begin series)
f. IPV
g. Varicella
h. Hib

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 37: Anticancer Drugs

 

Test Bank

 

MULTIPLE CHOICE

 

  1. A client with cancer is on chemotherapy and neutropenic precautions. This is a priority intervention because clients taking anticancer drugs are susceptible to infections resulting from a(n) _____ count.
a. decreased white blood cell
b. increased white blood cell
c. decreased platelet
d. decreased red blood cell

 

 

 

  1. A client is ordered to receive cyclophosphamide (Cytoxan). The client is advised to drink increased water and fluids to:
a. prevent renal failure.
b. prevent liver dysfunction.
c. prevent hemorrhagic cystitis.
d. increase the red blood cell count.

 

 

 

  1. A client is discharged on anticancer medications. What is an advantage of home use of these medications?
a. It can be closely monitored for potency of the drug.
b. Adequate hydration can be more easily provided in the home.
c. It is cost-effective for providing cancer care.
d. The client and family can readily monitor side effects and adverse reactions.

 

 

 

  1. The nurse suspects that the client may be experiencing peripheral neuropathy as a result of receiving paclitaxel (Taxol). What is the highest priority nursing intervention to use in monitoring the client for this adverse reaction?
a. Decrease in levels of white blood cells and platelets
b. Increase in overactive deep tendon reflexes
c. Numbness and/or tingling of the fingers and toes
d. Paralysis of the muscles in the lower extremities

 

 

 

  1. A client with cancer is taking an antimetabolite. The client complains of nausea. The nurse may suggest taking the drug with:
a. milk.
b. crackers.
c. yogurt.
d. a full meal.

 

 

  1. Estrogen therapy is a treatment for progressive prostatic cancer and breast cancer (postmenopausal women). The nurse administers the estrogen with the awareness that what is the proposed action of estrogen?
a. Suppresses tumor growth
b. Kills malignant tumor cells
c. Increases tumor growth
d. Stimulates normal cell growth

 

 

 

  1. To reduce a nurse’s exposure to chemotherapy drugs during IV administration, what is the nurse’s highest priority nursing intervention?
a. Wear a mask during administration of the medication.
b. Clean up a spill with paper towels as quickly as possible.
c. Wear a face shield if there is any danger of splashing.
d. Wear triple-layered gloves during administration.

 

 

  1. A client with cancer is being treated with medication via intravenous therapy. The client is noted to have swelling at the IV site, pain at the IV site, and cool and pale skin. What is the highest priority nursing intervention?
a. Consult the pharmacist.
b. Increase the rate of the infusion.
c. Stop the infusion.
d. Administer pain medication.

 

 

 

  1. The client will be undergoing anticancer therapy in the home setting. The nurse is preparing written educational materials for the client and family. In preparing the materials, the nurse’s highest priority intervention is to:
a. ensure that materials are written at a 10th-grade level.
b. assess the learning needs of the client and family.
c. provide information as an audio file as well as in written format.
d. provide detailed information on each medication given.

 

 

 

  1. The client is receiving chemotherapy while remaining in the home setting. To ensure that caregivers properly dispose of body fluids while the client is receiving these drugs, what is the nurse’s highest priority instruction to the client and caregiver?
a. Wear protective gloves and mask when flushing a toilet.
b. Wash soiled linen in cold water to prevent staining.
c. Flush the toilet twice while the client is receiving the drugs.
d. Clean the toilet with undiluted bleach while the client is receiving the drug.

 

 

 

  1. The client will be remaining in the home while receiving chemotherapy. Her caregiver is concerned about how her skin should be cleaned if she is incontinent while undergoing treatment. The nurse should instruct the caregiver to clean the skin with ________ after an incontinent episode.
a. soap and water
b. prescribed skin care products
c. diluted hydrogen peroxide
d. water-based lubricant

 

 

  1. A male client is receiving chemotherapy and is concerned about endangering his female sexual partner while he is receiving the drugs. The nurse’s highest priority instruction to this client is to __________ receiving the drugs.
a. continue to use his preferred method of birth control while
b. abstain from sexual activity for 7 days after
c. use a second form of birth control while
d. use condoms for up to seven days after

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 38: Targeted Therapies to Treat Cancer

 

Test Bank

 

MULTIPLE CHOICE

 

  1. A patient is ordered to receive an angiogenesis inhibitor called bevacizumab (Avastin). During a client teaching session, the nurse instructs the patient that the primary function of this medication is to:
a. prevent blood vessel growth in cancer tumors.
b. inhibit DNA replication in cancer cells.
c. treat opportunistic infections.
d. suppress inflammatory tumor growth.

 

 

 

  1. A patient is receiving targeted therapy for cancer and is told about apoptosis. The nurse explains that apoptosis refers to ________ cells.
a. duplication of cancer
b. slow, planned death of cancer
c. increase in the replication of normal
d. decrease in the blood flow to cancer

 

 

 

  1. A nurse is providing patient education about targeted cancer therapy. The nurse recognizes that the greatest disadvantage of this treatment is:
a. lack of effectiveness.
b. lack of research related to therapies.
c. significant cost of treatment.
d. extensive side effects and adverse reactions.

 

 

 

  1. The patient is trying to decide whether or not to use targeted cancer therapy. In teaching patients about targeted cancer therapy, the nurse teaches the patient that side effects:
a. frequently include hypotension and hirsutism.
b. are generally dose limiting.
c. usually are minor.
d. are usually predictable and may be treated proactively.

 

 

 

  1. A patient with colon cancer is being treated with bevacizumab (Avastin). The nurse monitors for nephrotic syndrome, a known side effect of this medication, by:
a. assessing for proteinuria.
b. frequently taking vital signs.
c. maintaining strict intake and output.
d. assessing for dehydration.

 

 

 

  1. The client is being treated with Rituxan. The nurse notices that the first IV infusion of the drug has been started at a rate of 100 mL/hr. The highest priority nursing intervention is:
a. increasing the rate of the infusion.
b. decreasing the rate of the infusion.
c. stopping the infusion completely.
d. calling the physician.

 

 

 

  1. The client is being treated with Herceptin. The nurse notes that the client is experiencing episodes of hypotension. The highest priority nursing intervention is to:
a. stop the infusion.
b. increase the rate of the infusion.
c. decrease the rate of the infusion.
d. notify the pharmacist.

 

 

 

  1. The client is being treated with 1200 mg of Vectibix. The nurse should plan to administer the infusion over a period of _____ minutes.
a. 15
b. 30
c. 60
d. 90

 

 

 

  1. The client is being treated with Sprycel. The nurse notes that the tablets have been broken. What is the highest priority nursing intervention?
a. Notify the physician and hold the medication.
b. Send the medication back to the pharmacy.
c. Don gloves to administer the medication.
d. Notify the pharmacist that tablets are broken.

 

 

 

MULTIPLE RESPONSE

 

  1. The nurse is teaching a patient how to manage medication-related diarrhea. What does the nurse include in the instructions? (Select all that apply.)
a. Encourage adequate fluid intake.
b. Use laxatives liberally.
c. Assess for fever and tarry stools.
d. Eat a high-fiber diet.
e. Take small, frequent feedings.
f. Maintain a bland diet.
g. Increase milk products.
h. Increase intake of caffeinated beverages.

 

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 39: Biologic Response Modifiers

 

Test Bank

 

MULTIPLE CHOICE

 

  1. The nurse reviews a medication history for a client prescribed sargramostim (Leukine) for treatment of acute myelogenous leukemia (AML). The client is being treated with all of the following medications. Which one will require the nurse to contact the healthcare provider?
a. Diphenhydramine (Benadryl)
b. Furosemide (Lasix)
c. Lithium (Eskalith)
d. Risperidone (Risperdal)

 

 

 

  1. A client with leukemia is receiving colony-stimulating factors (CSFs). The nurse anticipates that the client will be affected by the medication by exhibiting:
a. a decrease in the actual size of the tumor.
b. a decrease in length of posttreatment neutropenia.
c. an increase in fungus-destroying ability.
d. diminished bacterial infection.

 

 

 

  1. What does appropriate client teaching for clients receiving biologic response modifiers (BRMs) include?
a. Report weight loss and signs of infection or bleeding.
b. Severe weakness and malaise are expected side effects.
c. BRM therapy has no teratogenic effects.
d. Most BRM side effects persist after therapy is discontinued.

 

 

 

  1. A client is to receive filgrastim (Neupogen) as a granulocyte-stimulating factor. The nurse recognizes that this medication should not be given when the client has:
a. severe myelosuppression.
b. a history of hypertension.
c. received cytotoxic agents less than 24 hours before.
d. a neutrophil count lower than 500.

 

 

 

  1. A client is receiving interferon. What should be the highest priority nursing intervention to prevent the client from experiencing rigors?
a. Pretreat with acetaminophen (Tylenol) and meperidine (Demerol).
b. Provide antiemetics before treatment and around the clock.
c. Infuse IV fluids as quickly as possible and assess urine output.
d. Provide analgesia every 4 hours and assess for pain.

 

 

 

  1. A client is taking G-CSF, or filgrastim (Neupogen). Which nursing interventions are indicated for the most common side effect of this medication?
a. Stool softeners and a high-fiber diet for constipation
b. High fluid intake and vitamin C for alkaline urine
c. Acetaminophen (Tylenol) and assessment for fever
d. Nonnarcotic analgesia and comfort measures for pain

 

 

 

  1. A client is to receive oprelvekin (Neumega). The nurse confirms that the client is experiencing fluid retention related to the medication by monitoring the client for evidence of:
a. peripheral edema and exertional dyspnea.
b. bradycardia and hypotension.
c. restlessness and hypoxia.
d. hypothermia and ventricular dysrhythmias.

 

 

 

  1. The nurse is administering erythropoietin. The nurse anticipates that the client will experience which side effects of receiving the medication?
a. Orthostatic hypotension and dizziness
b. Shortness of breath and tachypnea
c. Bradycardia and agonal respirations
d. Headaches and hypertension

 

 

 

  1. The highest priority nursing intervention to prevent the client from experiencing fatigue related to biologic response modifiers is to administer the drug:
a. with iron to prevent anemia.
b. with high-calorie foods to protect the stomach.
c. before bedtime to allow the patient to sleep.
d. with high-fat food to provide quick energy.

 

 

 

  1. The client is scheduled to receive treatment with Leukine. She is currently receiving treatment with lithium. As a result of the interaction of the medications, the nurse anticipates that the client will experience a(n) _____ effect of the _____.
a. increased; Leukine
b. increased; lithium
c. decreased; Leukine
d. decreased; lithium

 

 

 

  1. The client is being treated with Epoetin Alfa. The nurse notes that his blood pressure, which had a baseline reading of 114/82, has risen to stay consistently at 142/90 or higher. What is the highest priority action on the part of the nurse?
a. Contact the physician; this is indicative of an adverse reaction to the medication.
b. Contact the pharmacist; this is indicative of the drug being prepared in error.
c. Contact the pharmacist; this indicates the client is experiencing an anaphylactic reaction.
d. Contact the physician; this is an expected side effect of the medication.

 

 

 

  1. The client is being treated with Epoetin Alfa. The nurse expect to see in the client’s laboratory values a(n) _____ hematocrit and a(n) _____ plasma volume.
a. decreased; increased
b. increased; decreased
c. decreased; decreased
d. increased; increased

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 40: Drugs for Upper Respiratory Disorders

 

Test Bank

 

MULTIPLE CHOICE

 

  1. The client is experiencing cold symptoms. The nurse anticipates that the client will be ordered:
a. antivirals.
b. antifungals.
c. antitussives.
d. antibiotics.

 

 

 

  1. A client is ordered to receive azelastine (Optivar) nasal spray. This antihistamine has a half-life of 22 hours. The nurse anticipates this medication to be ordered _____ per day.
a. once
b. twice
c. three times
d. four times

 

 

 

  1. A client has had a sinus infection for 1 week. She was seen in the clinic 4 days ago and was instructed to take over-the-counter decongestants and antipyretics. She returns to the clinic with continued symptoms and green nasal mucus. The nurse anticipates that which medication will be ordered?
a. Narcotic
b. Antibiotic
c. Antiviral agent
d. Antifungal agent

 

 

 

  1. The client is being ordered Robitussin DM. He complains of experiencing dizziness. What is the highest priority nursing intervention?
a. Call the physician; this is indicative of an anaphylactic reaction to the medication.
b. Call the physician; this is an expected side effect of the medication.
c. Call the pharmacist; this is evidence that the drug was prepared incorrectly.
d. Call the pharmacist; this is evidence that this is not the correct drug.

 

 

 

  1. The client has been taking Robitussin DM in the home setting. The nurse suspects that she is taking an excessive amount of the medication when she complains of:
a. nausea.
b. drowsiness.
c. hallucinations.
d. bloody sputum.

 

 

 

  1. The client has been ordered Nasonex. The highest priority instruction that the nurse should give the client is to direct the spray:
a. upwards in the nasal passages.
b. downwards in the nasal passages.
c. towards the nasal septum.
d. away from the nasal septum.

 

 

 

  1. The client is taking Flonase in the home setting. Once the client’s symptoms have subsided; the nurse’s highest priority instruction to the client should be to reduce the spray to:
a. three times daily.
b. two times daily.
c. once daily.
d. once every other day.

 

 

 

  1. The client tells the nurse that he has been taking Neo-Synephrine for the past month. What is the nurse’s highest priority response to the client?
a. Neo-Synephrine can be taken indefinitely while it is still effective.
b. Neo-Synephrine should not be taken longer than 24 hours.
c. Neo-Synephrine can be taken until symptoms decrease.
d. Neo-Synephrine should not be taken for longer than 3 to 5 days.

 

 

 

  1. The client requires a nasal decongestant and tells the nurse that she is very interested in using herbal remedies. She has been using peppermint as an herbal decongestant. The nurse’s most accurate interpretation of this is that peppermint __________ nasal decongestant.
a. can be effectively used as an herbal
b. is usually ineffective when used as a
c. can cause an anaphylactic reaction when used as a
d. can cause fatality when used as a

 

 

 

  1. The client has symptoms of the common cold and is to be treated with a decongestant nasal spray. What is the nurse’s highest priority instruction to the client?
a. Use as many puffs as needed as often as necessary for up to 10 days.
b. Use one to two puffs four to six times daily for up to 5 to 7 days.
c. Use no more than one puff three times daily for up to 7 days.
d. Use two puffs two times daily for no longer than 3 days.

 

 

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 41: Drugs for Lower Respiratory Disorders

 

Test Bank

 

MULTIPLE CHOICE

 

  1. The nurse instructs a client to administer montelukast (Singulair):
a. in the morning.
b. at noon.
c. late in the afternoon.
d. in the evening.

 

 

 

  1. A client who smokes is receiving theophylline products. Because of his history of smoking, the nurse would expect that the dose would be affected in which way?
a. Increased
b. Decreased
c. The same
d. Closely monitored

 

 

 

  1. A nurse is teaching a client about the side effects and adverse reactions of theophylline (Theo-Dur). The side effects include:
a. headache and an aura.
b. hypertension and flushing.
c. tachycardia and palpitations.
d. diarrhea and dehydration.

 

 

 

  1. When using a mucolytic drug and a bronchodilator in a nebulizer, the highest priority instruction that the nurse should give the client is that the _____ should be given _____ minutes before the _____.
a. mucolytic drug; 30; bronchodilator
b. bronchodilator; 30; mucolytic drug
c. mucolytic drug; 5; bronchodilator
d. bronchodilator; 5; mucolytic drug

 

 

 

  1. Clients taking a theophylline drug must be aware of herbal drug(s) that may cause drug interaction. Which is an herb that can cause cardiac dysrhythmias and theophylline toxicity when taken with theophylline?
a. Ginkgo
b. Ginseng
c. Ginger
d. Ephedra

 

 

 

  1. A client who uses an inhaler is taught strategies to prevent Candida infections. Which instruction would the nurse include in the teaching?
a. Soak the spacer in alcohol between uses.
b. Do not use a spacer.
c. Rinse the mouth with water after each use.
d. Use fluconazole (Diflucan) prophylactically.

 

 

 

  1. A client is ordered to receive metaproterenol (Alupent) for asthma by inhaler, rather than orally. The nurse recognizes that when the medication is given by inhaler rather than orally:
a. the inhaled dose is higher than the oral dose.
b. the onset of the inhaled dose is faster than that of the oral dose.
c. there are more side effects with the inhaled dose.
d. the oral dose has a shorter half-life.

 

 

 

  1. The client is ordered to be treated with Singulair. The nurse anticipates the client will experience what type of change in her laboratory values?
a. Abnormal liver function tests
b. Hyperglycemia
c. Increased potassium level
d. Change in cardiac enzymes

 

 

 

  1. The client is being treated with Alupent. The nurse anticipates the client will experience what type of change in his laboratory values?
a. Hypoglycemia
b. Decreased serum potassium
c. Increased calcium
d. Decreased serum magnesium

 

 

 

  1. The client is being treated with Alupent. The client is also being treated with a beta-blocker drug. The nurse anticipates that the interaction of the two drugs will result in:
a. increased action of the Alupent.
b. toxicity of the beta blocker.
c. decreased action of the Alupent.
d. anaphylactic reaction to the beta blocker.

 

 

 

  1. The client has been started on Zyflo. The nurse’s highest priority intervention while the client is receiving this medication is to monitor:
a. liver enzymes.
b. serum glucose.
c. calcium level.
d. potassium level.

 

 

 

  1. The client has been started on an oral dosage of aminophylline. The nurse recognizes that the dosage of this medication is prepared based on the client’s:
a. remaining medication regimen.
b. body weight in kilograms.
c. breathing pattern and lung capacity.
d. current pulmonary function test.

 

 

 

  1. The client is ordered to receive Mucomyst after an overdose of acetaminophen. The nurse recognizes that the most effective time for the client to receive the drug is _____ hours after the overdose.
a. 8 to 12
b. 12 to 24
c. 24 to 36
d. 36 to 48

 

 

 

  1. To promote elimination of theophylline from the client’s system, the client’s diet should emphasize high _____ and low _____.
a. fat; carbohydrate
b. carbohydrate; fat
c. fiber; protein
d. protein; carbohydrate

 

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 42: Cardiac Glycosides, Antianginals, and Antidysrhythmics

 

Test Bank

 

MULTIPLE CHOICE

 

  1. A client is ordered to receive digoxin (Lanoxin). Based on its half-life of 36 hours, the nurse will anticipate administering the maintenance dose:
a. once a day.
b. twice a day.
c. three times a day.
d. once a week.

 

 

 

  1. The client is being treated with digoxin. She tells the nurse that she frequently self-medicates her depression with St. John’s wort. What is the nurse’s highest priority instruction to the client?
a. Take the St. John’s wort; it will have no effect on the digoxin.
b. Do not take St. John’s wort; it will cause a toxic reaction to the digoxin.
c. Do not take St. John’s wort; it decreases the effectiveness of the digoxin.
d. Take the St. John’s wort; it will enhance the effect of the digoxin.

 

 

 

  1. Which symptom would cause the nurse to suspect that the client is experiencing digitalis toxicity?
a. Abdominal cramping
b. Bradycardia
c. Polyuria
d. Hearing disturbances

 

 

 

  1. The nurse instructs a client taking digoxin (Lanoxin) for treatment of congestive heart failure (CHF) to eat:
a. cabbage.
b. lima beans.
c. potatoes.
d. yogurt.

 

 

 

  1. The client is being treated with Lanoxin and is also self-medicating with antacids. The nurse expects the combination of these medications to result in _____ digoxin.
a. anaphylactic reaction to the
b. increased absorption of
c. decreased absorption of
d. toxicity of the

 

 

 

  1. A client is demonstrating signs and symptoms of digoxin toxicity. The nurse anticipates that the client will be treated with:
a. vitamin K.
b. digoxin immune Fab (Digibind).
c. inamrinone lactate (Inocor).
d. naloxone (Narcan).

 

 

 

  1. A nurse is preparing to administer nitroglycerin (NTG) via the sublingual route. The nurse knows that nitroglycerin tablets are administered sublingually to:
a. avoid the bitter taste.
b. prevent nausea and vomiting.
c. absorb readily into the circulation.
d. undergo first-pass metabolism.

 

 

 

 

  1. A client was prescribed a transdermal nitroglycerin patch, 5 mg/24 hr. What is an important point of instruction for the client?
a. Leave the old patch on when applying the new patch.
b. Change to a new site when applying the new nitroglycerin patch.
c. Apply the nitroglycerin patch only to the chest area.
d. The patch medication area may be touched while applying it.

 

 

 

  1. A client is ordered to take inamrinone lactate (Inocor) for treatment of acute heart failure. The nurse anticipates that this drug will be administered intravenously for no longer than _____ hours.
a. 12
b. 24
c. 36
d. 72

 

 

 

  1. Nifedipine (Procardia), the most potent calcium blocker, promotes vasodilation of the coronary and peripheral vessels. While the client is taking the drug, the nurse’s highest priority intervention is to monitor for:
a. elevated blood pressure.
b. decreased blood pressure.
c. pulse rate less than 70 beats/minute.
d. pulse rate greater than 120 beats/minute.

 

 

 

  1. A client experiences premature ventricular contractions. The nurse prepares to administer lidocaine (Xylocaine), with the knowledge that it is administered intravenously to correct:
a. bradycardia.
b. atrial dysrhythmias.
c. ventricular dysrhythmias.
d. heart block.

 

 

 

  1. The nurse notes that the client is ordered to receive flecainide (Tambocor) and tocainide (Tonocard). The nurse anticipates that the client has been diagnosed with:
a. life-threatening ventricular dysrhythmias.
b. third-degree heart block.
c. bundle branch block.
d. asystole.

 

 

 

  1. A nurse is caring for a client with congestive heart failure. The client is ordered to receive nesiritide (Natrecor). The nurse evaluates the effectiveness of this medication by noting which desired effect?
a. Vasoconstriction
b. Oliguria
c. Decreased diuresis
d. Decreased shortness of breath

 

 

 

  1. A client is ordered to receive a nitrate to relieve stable angina. What is(are) a common side effect(s) to anticipate in a client receiving this medication?
a. Nausea and vomiting
b. Increased blood pressure
c. Pruritus and skin rash
d. Pounding headache

 

 

 

  1. The client has been ordered to be treated with Sectral. She is also being treated with a diuretic. The nurse anticipates that the interaction of the two drugs will result in a(n) _____ effect of the _____.
a. increased; Sectral
b. increased; diuretic
c. decreased; Sectral
d. decreased; diuretic

 

 

 

  1. The client has been ordered to be treated with Sectral. The nurse anticipates that the client will experience an increase in which laboratory value?
a. Calcium
b. Potassium
c. Magnesium
d. Glucose

 

 

 

  1. The client is being treated with Nitro-stat. She is also being treated with heparin. The nurse anticipates that the combination of the two medications will result in a(n) _____ effect of the _____.
a. increased; Nitro-stat
b. increased; heparin
c. decreased; Nitro-stat
d. decreased; heparin

 

 

 

  1. The nurse is preparing a dose of Lanoxin for a pediatric client. The nurse recognizes that the pediatric medication takes which form?
a. Elixir
b. Tablet
c. Lozenge
d. Infusion

 

 

 

  1. The client is being treated with Lanoxin. He is also being treated with quinidine. The nurse anticipates that the combination of the two drugs will result in a(n) _____ level.
a. increased quinidine
b. decreased digoxin
c. increased digoxin
d. decreased quinidine

 

 

 

  1. The client is being treated with Lanoxin and complains to the nurse of experiencing blurred vision. The highest priority nursing intervention is to recognize that this:
a. is an expected side effect of the medication; notify the physician.
b. is indicative of an anaphylactic reaction to the medication.
c. is an adverse reaction to the medication; notify the physician.
d. indicates an error in mixing the medication; notify the pharmacist.

 

 

 

MULTIPLE RESPONSE

 

  1. A client has congestive heart failure and has been taking digoxin (Lanoxin) for 9 years. The client is admitted with signs and symptoms of digoxin toxicity. Which signs and symptoms are associated with digoxin toxicity? (Select all that apply.)
a. Scomota
b. Vomiting
c. Supraventricular tachycardia
d. Yellow halos in the visual field
e. Diarrhea
f. Insomnia

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 43: Diuretics

 

Test Bank

 

MULTIPLE CHOICE

 

  1. Thiazide diuretics are contraindicated if the client has:
a. emphysema.
b. arteriosclerotic cardiovascular disease.
c. renal failure.
d. viral infection.

 

 

 

  1. Client teaching for a client taking a thiazide diuretic includes which instruction?
a. Instruct the client to add salt liberally to his food.
b. Instruct the client to decrease intake of potassium-rich foods.
c. Instruct the client to check pulse rate if digoxin is taken with hydrochlorothiazide.
d. Advise the client to rise slowly from a sitting to a standing position.

 

 

 

  1. A client is taking a thiazide diuretic. The nurse assesses the client’s serum glucose level—the fasting blood glucose level is 150 mg/dl. What is an appropriate response by the nurse?
a. Instruct the client to discontinue taking hydrochlorothiazide.
b. Inform the healthcare provider of the glucose level and the possible need for a different diuretic.
c. Instruct the client to take hydrochlorothiazide every other day.
d. Instruct the client to take an antidiabetic drug instead of the diuretic.

 

 

 

  1. A nurse is teaching a client about lifestyle changes when taking a potassium-sparing diuretic. Which statement indicates a need for more teaching?
a. “I need to have my blood drawn frequently.”
b. “I need to call the clinic if I am urinating less than every 2 hours.”
c. “I need to be careful when out in the sun.”
d. “I need to eat foods like bananas frequently.”

 

 

 

  1. A client is ordered to receive triamterene (Dyrenium) to decrease her blood pressure. The nurse is evaluating the effectiveness of the medication in returning the blood chemistries to normal. A positive response to the medication is indicated by a(n) _____ K level and a(n) _____ Na level.
a. increased; decreased
b. increased; increased
c. decreased; decreased
d. decreased; increased

 

 

 

  1. The client is being treated with furosemide as well as an aminoglycoside. What effect should the nurse expect to see as a result of the interaction of the drugs?
a. Blurred vision
b. Ototoxicity
c. Bone pain
d. Blood-tinged urine

 

 

 

  1. The client is being treated with furosemide and a steroid drug as well. As a result of the interaction of the drugs, the nurse should expect to see an increased loss of:
a. potassium.
b. calcium.
c. magnesium.
d. sodium.

 

 

 

  1. The client is being treated with a thiazide diuretic. The nurse should expect to see an increased serum _____ as a result of treatment with this drug.
a. potassium
b. sodium
c. magnesium
d. calcium

 

 

 

  1. The client is being treated with chlorthalidone (Hygroton). In determining the proper time to schedule dosages, the nurse recognizes that the duration of action for the medication is up to _____ hours.
a. 12
b. 24
c. 48
d. 72

 

 

 

  1. The client is being treated with a thiazide diuretic. He tells the nurse that he is interested in using herbal preparations and frequently self-medicates with ginkgo. The nurse’s most appropriate response to this information is:
a. “Ginkgo can be effectively used with a thiazide diuretic since it decreases blood pressure.”
b. “Ginkgo can be used with a thiazide diuretic since it prolongs medication’s action.”
c. “Ginkgo should not be used with a thiazide diuretic since it increases blood pressure.”
d. “Ginkgo should not be used with a thiazide diuretic since it may cause toxicity.”

 

 

 

  1. The client is being treated with a thiazide diuretic as well as digoxin. He complains to the nurse of experiencing blurred vision. The highest priority nursing intervention is to call the physician because blurred vision:
a. is indicative of digoxin toxicity.
b. is indicative of an anaphylactic reaction.
c. indicates an inadequate dosage of the diuretic.
d. indicates an overdose of the diuretic.

 

 

 

  1. The client is being treated with a thiazide diuretic. The nurse anticipates that the medication will be administered at:
a. 8:00 AM.
b. 11:30 AM.
c. 4:30 PM.
d. 9:00 PM.

 

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 44: Antihypertensives

 

Test Bank

 

MULTIPLE CHOICE

 

  1. The client has been diagnosed as being borderline hypertensive. As part of client teaching, the nurse should emphasize that the client can potentially avoid being placed on medication if he will attempt which changes?
a. Weight reduction and restricted salt intake
b. Stress reduction techniques and higher caloric intake
c. Decreased weight-bearing exercise and decreased fat intake
d. Decreased fluid intake and increased potassium intake

 

 

 

  1. The client is a Native American who has been diagnosed as having hypertensive disease. In conferring with the primary health provider, the nurse recognizes that which antihypertensive medication would not be effective with this client?
a. Furosemide (Lasix)
b. Metoprolol (Apo-Metoprolol, Toprol SR)
c. Minoxidil (Loniten, Rogaine)
d. Prazosin (Minipress)

 

 

 

  1. A client is ordered to receive propranolol (Inderal). The nurse notes that the client has a history of asthma. The nurse calls the ordering physician with the knowledge that propranolol may cause:
a. no change in airway.
b. bronchial constriction.
c. bronchial dilation.
d. bronchial enlargement.

 

 

 

  1. The client has been ordered treatment with minoxidil (Loniten) to control her hypertension. In designing a client teaching session, the nurse anticipates that the primary health provider will likely order which drug to increase the effectiveness of the minoxidil (Loniten)?
a. Cardiac glycosides
b. Diuretics
c. Glucocorticoids
d. Antihistamines

 

 

 

  1. The nurse is designing a client teaching session for a hypertensive client who has just been placed on antihypertensive medication. He tells the nurse that he typically drinks two glasses of wine each night. The best reply by the nurse is “Alcohol should not be taken with antihypertensives because the combination may:
a. increase the hypertensive state.”
b. increase the hypotensive state.”
c. lead to renal failure.”
d. lead to a toxic level of the medication.”

 

 

 

 

 

  1. A nurse is providing health teaching for clients taking antihypertensives. The highest priority teaching point regarding discontinuation of the drug is that abrupt discontinuation of the drug may result in:
a. drowsiness.
b. nasal stuffiness.
c. rebound hypotension.
d. rebound hypertension.

 

 

 

  1. The client has been ordered to be treated with Losartan potassium. What effect should the nurse expect to see in the client’s laboratory values?
a. Decreased liver enzymes
b. Increased BUN and creatinine
c. Decreased serum glucose
d. Increased calcium

 

 

 

  1. The client has been ordered to be treated with Minipress. She complains to the nurse of experiencing rapid heart rate. The highest priority nursing intervention is to call the physician because a rapid heart rate:
a. is an expected side effect of the medication.
b. is evidence of an anaphylactic reaction.
c. is evidence of an adverse reaction to the medication.
d. shows that the medication was mixed incorrectly.

 

 

 

  1. The client is being treated with metoprolol. The nurse notes that the client has been experiencing sinus bradycardia. What is the highest priority nursing intervention?
a. Call the physician; the medication is contraindicated if there is sinus bradycardia.
b. Teach the client that the medication schedule must be strictly adhered to.
c. Call the physician; the dosage should be increased when there is sinus bradycardia.
d. Teach the client that he should notify the physician if he experiences rapid heart rate.

 

 

 

  1. The client is being treated with metoprolol as well as digitalis. The nurse anticipates the interaction of these two drugs will result in an increased incidence of:
a. tachycardia.
b. heart block.
c. bradycardia.
d. cardiac pauses.

 

 

 

  1. The client is being treated with eplerenone (Inspra). The nurse recognizes that which laboratory value must be monitored most closely while the client is on this medication regimen?
a. Calcium
b. Potassium
c. Sodium
d. Magnesium

 

 

 

  1. The client is being treated with captopril (Capoten). The nurse teaches the client that while she is on the medication, she should avoid eating a diet that is rich in which:
a. potassium.
b. calcium.
c. iron.
d. folic acid.

 

 

 

  1. The client has been started on a treatment regimen that includes fosinopril (Monopril). The nurse realizes that the client has also been diagnosed with renal insufficiency. What is the most accurate nursing intervention?
a. Call the physician; the medication is contraindicated.
b. Teach the client that the side effects of the drug will be intensified.
c. Call the physician; the dosage will need to be decreased.
d. Give the medication as ordered.

 

 

 

  1. The client is being treated with sodium nitroprusside (Nipride, Nitropress). As the nurse is preparing to administer the medication, the most important thing to verify is that the container is:
a. wrapped in aluminum foil.
b. a glass bottle.
c. a plastic bag.
d. tinted a dark color.

 

 

 

  1. The client is being treated with sodium nitroprusside (Nipride, Nitropress). The nurse notes that the medication is tinted red. What is the highest priority nursing intervention in response to this observation?
a. Administer the medication as ordered.
b. Call the pharmacist since the medication should be tinted blue.
c. Discard the medication; it should not be tinted red.
d. Call the physician since this indicates that the dosage is wrong.

 

 

 

MULTIPLE RESPONSE

 

  1. A client is ordered to receive an antihypertensive medication. Which elements should be included in teaching? (Select all that apply.)
a. Warn the client to rise slowly to avoid orthostatic hypotension.
b. Tell the client to limit water intake.
c. Tell the client to limit potassium intake.
d. Tell the client to eat a high-sodium diet.
e. Discuss potential side effects of the medication.
f. Tell the client to stop the medication if blood pressure is within normal limits.

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 45: Anticoagulants, Antiplatelets, and Thrombolytics

 

Test Bank

 

MULTIPLE CHOICE

 

  1. The client who is most likely to be ordered low–molecular-weight heparin would be the client who is considered to be at high risk to develop:
a. venous thrombosis.
b. arterial embolism.
c. thrombocytopenia.
d. leukopenia.

 

 

 

  1. A client is to receive a heparin injection. The highest priority nursing intervention before administration of the medication is to check the:
a. PT and INR.
b. PTT and APTT.
c. CBC.
d. platelet count.

 

 

 

  1. In planning care for a client receiving heparin, the nurse is aware that the dose is administered subcutaneously. What is the reason for using this route?
a. Heparin is absorbed readily by the gastrointestinal mucosa and protected by the liver.
b. Heparin is poorly absorbed by the gastrointestinal mucosa and destroyed by liver enzymes.
c. The effective absorption of heparin can be hampered by food.
d. The effective absorption of heparin is hampered by the stomach’s inadequate blood flow.

 

 

 

  1. A client is being treated with warfarin (Coumadin). The highest priority nursing intervention before administration of the medication is to check the:
a. PTT and APTT.
b. PT and INR.
c. most current CBC.
d. most current platelet count.

 

 

 

  1. A client receiving warfarin (Coumadin) is noted to have significant bleeding from the gums while on therapy. The physician orders an antidote. If excess bleeding occurs because of warfarin accumulation in the body, what is the antidote?
a. Vitamin K
b. Vitamin E
c. Naloxone (Narcan)
d. Protamine sulfate

 

 

 

  1. Which statement made by a client receiving (warfarin) Coumadin therapy indicates a need for further teaching?
a. “I shouldn’t take aspirin while I’m on Coumadin.”
b. “I will use a toothbrush with soft bristles.”
c. “I will eat large quantities of green leafy vegetables.”
d. “I will use an electric razor to avoid shaving cuts.”

 

 

 

  1. The client has been ordered treatment with warfarin. She tells the nurse that she self-medicates with herbal remedies as much as possible. The highest priority teaching point that the nurse should give the client is the avoid the use of _____ while taking warfarin.
a. ephedra and dill
b. black cohosh and licorice
c. garlic and ginkgo
d. ginseng and green tea

 

 

 

  1. The client has received an overdose of a thrombolytic drug. The nurse anticipates that he will be treated with:
a. naloxone (Narcan).
b. protamine sulfate.
c. vitamin E.
d. aminocaproic acid (Amicar).

 

 

 

  1. A new nurse is listing the interventions he should employ when caring for a client on thrombolytic therapy. Which nursing intervention is inappropriate for the client during thrombolytic therapy?
a. Monitor vital signs and reporting changes.
b. Check for active bleeding for 24 hours after therapy.
c. Inform the client that aspirin and NSAIDs may be taken for discomfort.
d. Monitor electrocardiogram strips for cardiac dysrhythmias.

 

 

 

  1. A client receiving clopidogrel (Plavix) has the following conditions as part of the health history. Which causes the greatest concern to the nurse?
a. Asthma
b. Glaucoma
c. Allergy to shellfish
d. Active peptic ulcer

 

 

 

  1. The client is being treated with Plavix. He complains to the nurse of experiencing chest pain. The highest priority nursing intervention is to call the physician because the client is experiencing a(n):
a. adverse reaction to the medication.
b. myocardial infarction.
c. expected side effect of the medication.
d. anaphylactic reaction to the medication.

 

 

 

  1. The client is being treated with heparin and also with nitroglycerin. The nurse anticipates that the interaction of the two drugs will produce which effect?
a. Inadequate effect from the nitroglycerin
b. Decreased effect from the heparin
c. Toxic dose of the nitroglycerin
d. Increased effect from the heparin

 

 

 

  1. The client is being treated with warfarin sodium as well as a diuretic. The nurse anticipates that the interaction of the two drugs will produce a(n) _____ effect from the _____.
a. increased; warfarin sodium
b. decreased; warfarin sodium
c. increased; diuretic
d. decreased; diuretic

 

 

 

  1. The client is being treated with warfarin sodium. She complains to the nurse of soreness in her mouth. The highest priority nursing intervention is to call the physician because the client is _____ the medication.
a. beginning to hemorrhage from
b. developing a clot from
c. experiencing an expected side effect of
d. experiencing an adverse reaction to

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 46: Antihyperlipidemics and Peripheral Vasodilators

 

Test Bank

 

MULTIPLE CHOICE

 

  1. A client’s serum cholesterol level is 268 mg/dl. Lovastatin (Mevacor) is prescribed. A positive outcome of treatment with the medication is ________ of cholesterol.
a. inhibition of hepatic synthesis
b. stimulation of hepatic synthesis
c. an increase in renal excretion
d. an increase in fecal excretion

 

 

 

  1. The level of risk for coronary artery disease for a client with a serum cholesterol level of 270 mg/dl is _____ risk.
a. low
b. moderate
c. high
d. no

 

 

 

 

  1. The nurse assesses a client for side effects of lovastatin (Mevacor). Which symptom would be least likely to be associated with Mevacor?
a. Headache
b. Tachycardia
c. Gastrointestinal (GI) disturbances
d. Dizziness

 

 

 

  1. Which laboratory test would be highest priority for the nurse to monitor while a client receives treatment with the statin medications?
a. CBC
b. Electrolytes
c. Liver enzymes
d. Urinalysis

 

 

 

  1. Which symptom would be highest priority for the nurse to monitor while the client is being treated with peripheral vasodilators?
a. Bradycardia
b. Dizziness
c. Headache
d. Pallor

 

 

  1. A client is receiving atorvastatin (Lipitor) for high blood cholesterol level. Which sign warrants the client’s immediate contacting of the healthcare provider?
a. Muscle tenderness
b. Gastrointestinal distress
c. Constipation
d. Flushing of the skin

 

 

  1. A nurse is teaching a client about the treatment of hyperlipidemia and use of statin drugs. What do the instructions include?
a. “This treatment is only temporary.”
b. “Diet and exercise are secondary to treatment.”
c. “Annual eye examinations are recommended.”
d. “Diarrhea is a common side effect.”

 

 

 

  1. A nurse is monitoring a client after the client has received pentoxifylline (Trental) for treatment of intermittent claudication. Which effect indicates a positive response to the medication?
a. Increased claudication
b. Bradycardia
c. Decrease in pain
d. Orthostatic hypotension

 

 

 

  1. A client is to receive simvastatin (Zocor) to reduce serum cholesterol levels. The nurse recommends to the client that the best time to take this medication is:
a. before breakfast.
b. during meals.
c. in the mid-afternoon.
d. in the evening.

 

 

 

  1. A client diagnosed with hyperlipidemia has been prescribed cholestyramine (Questran). Which of the following instructions will the nurse include in the client’s teaching plan?
a. Mix powder sparingly with fluid.
b. Eat a low-fiber diet.
c. Mix powder well with fluid.
d. Take an antidiarrheal agent if diarrhea occurs.

 

 

 

  1. The client is being treated with Atorvastatin (Lipitor). He tells the nurse that he has been self-medicating at home with antacids. The nurse anticipates that the interaction of the two drugs will produce a(n) _____ effect from the _____.
a. increased; Atorvastatin (Lipitor)
b. decreased; Atorvastatin (Lipitor)
c. increased; antacids
d. decrease; antacids

 

 

 

  1. The client is being treated with ergoloid mesylates (Hydergine). The nurse determines that the medication is producing a positive outcome for the client when the client is noted to be exhibiting a(n):
a. improvement in mood.
b. decrease in blood pressure.
c. decrease in serum cholesterol.
d. change in GI functioning.

 

 

 

  1. The client is taking fenofibrate (Tricor). The highest priority nursing intervention with this medication is to monitor serum:
a. potassium.
b. glucose.
c. creatinine.
d. sodium.

 

 

 

  1. The client is scheduled to begin treatment with Isoxsuprine. In preparing the teaching plan for the client, the nurse anticipates that the client will be taking the drug _____ daily.
a. once
b. 1 to 2 times
c. 2 to 3 times
d. 3 to 4 times

 

 

 

MULTIPLE RESPONSE

 

  1. A client with high cholesterol is ordered to take atorvastatin (Lipitor). What information should be included in the client teaching? (Select all that apply.)
a. Dietary management is not a priority with this medication.
b. The medication should be taken on an empty stomach.
c. The medicine should be taken with a full glass of water.
d. The client should watch for body aches or GI upset as side effects.
e. The client should have renal function tests frequently.
f. The client should have liver function tests frequently.

 

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 47: Drugs for Gastrointestinal Tract Disorders

 

Test Bank

 

MULTIPLE CHOICE

 

  1. The client is planning a lengthy trip by automobile. She plans to leave her home at 8:00 AM. When should she plan to take her dimenhydrinate (Dramamine) to prevent motion sickness?
a. 6:30 AM
b. 7:00 AM
c. 7:30 AM
d. 8:00 AM

 

 

 

  1. The client has been prescribed an antihistamine anticholinergic medication. The nurse anticipates that the client will need a teaching plan regarding management of:
a. drowsiness and dry mouth.
b. bradycardia and fatigue.
c. tachycardia and dyspnea.
d. abdominal cramps and nausea.

 

 

 

  1. A client has been ordered a phenothiazine medication as part of his treatment regimen for a psychiatric disorder. Because he is taking the medication for this purpose, the nurse will prepare a dosage of medication that is:
a. larger than the dose he would take for vomiting.
b. smaller than the dose he would take for vomiting.
c. equal to the amount that he would take for vomiting.
d. smaller than the dose for vomiting and given by injection.

 

 

 

  1. A school nurse is preparing to administer syrup of ipecac after an ingestion of a noncaustic substance. The label instructs the nurse that the ipecac should be mixed in a glass of:
a. water.
b. ginger ale.
c. milk.
d. juice.

 

 

 

  1. A nurse is teaching caregivers about syrup of ipecac. Caregiver teaching includes the need to observe for vomiting in response to the ipecac within _____ minutes.
a. 5 to 10
b. 10 to 15
c. 15 to 30
d. 60 to 90

 

 

 

  1. Which child would not be a candidate for treatment with syrup of ipecac?
a. 2-year-old who has swallowed chlorine bleach
b. 4-year-old who has swallowed a poisonous substance and is alert
c. 10-year-old who swallowed cold tablets 45 minutes ago
d. 6-year-old who swallowed acetaminophen tablets 90 minutes ago

 

 

 

  1. A client has had diarrhea for 36 hours. The healthcare provider orders diphenoxylate with atropine (Lomotil). The nurse should contact the physician if the client has a history of:
a. heart disease.
b. diabetes mellitus.
c. glaucoma.
d. neuropathy.

 

 

 

  1. What is the highest priority health teaching for a client who has taken an antidiarrheal medication?
a. Instruct the client to avoid taking sedatives or tranquilizers with the antidiarrheal.
b. Advise the client to consume all food with milk products until diarrhea ceases.
c. Advise the client that overuse of antidiarrheals may result in continuous diarrhea.
d. Instruct the client to withhold water and fluids until diarrhea has ceased.

 

 

 

  1. Clients who are traveling abroad will ask how to avoid “traveler’s diarrhea.” What suggestion should be offered?
a. Pack bottled water and plan to drink only that during the trip.
b. Take a dose of Pepto-Bismol with each meal for prevention.
c. Take a dose of Loperamide (Imodium) daily for prevention.
d. Eat salads and fruits that come from the destination country.

 

 

 

 

  1. The nurse is concerned about the client’s loss of fluids and electrolytes because of diarrhea. The best dietary recommendation that the nurse can give is for the client’s diet to include which foods or drinks?
a. Tea and dry toast
b. Plain crackers and orange juice
c. Gatorade or Pedialyte
d. Ensure liquid supplement

 

 

 

 

  1. The client has been started on a treatment regimen that includes psyllium. The most important instruction that the nurse can give the client regarding preparation of the dose is to mix the dosage in _____ ounces of water and follow it with _____ ounces of water.
a. 4; 4
b. 8; 8
c. 10; 10
d. 12; 12

 

 

 

 

  1. The client has been started on a regimen that includes bisacodyl. The nurse notes that she has developed hypokalemia. The highest priority nursing intervention is to call the physician because this is _____ the medication.
a. an expected side effect to
b. indicative of an anaphylactic reaction to
c. an adverse reaction to
d. indicative of a toxic dosage of

 

 

 

 

  1. The client has been ordered to be treated with Lomotil. He is also being treated with an MAO inhibitor drug. Because of this combination of medications, the nurse must be vigilant in monitoring:
a. blood pressure.
b. pulse.
c. respirations.
d. temperature.

 

 

 

 

  1. The client has been ordered to be treated with Lomotil. She tells the nurse that she takes antihistamines for treatment of seasonal allergies. The best response from the nurse is that the combination of Lomotil and antihistamines can:
a. enhance the response from the Lomotil.
b. result in chronic diarrhea.
c. result in an anaphylactic reaction.
d. result in CNS depression.

 

 

 

 

  1. The client has been ordered to be treated with Phenergan. Which aspect of the client’s medical history would cause the nurse to notify the physician?
a. Allergy to milk products
b. Hypertension
c. Cataracts
d. Mental depression

 

 

 

 

  1. The client is taking GoLYTELY in preparation for a GI examination. What is the highest priority instruction that the nurse can give the client in preparing to take the medication?
a. “Have the solution at room temperature when drinking it.”
b. “Plan to allow at least 8 hours to drink the solution.”
c. “Fasting is not recommended for this examination.”
d. “Plan to fast for 3 to 4 hours.”

 

 

 

 

  1. The client is being treated with FiberCon. The highest priority instruction that the nurse should give the client regarding administration of the medication is to:
a. chew the tablet and take nothing else by mouth.
b. swallow the tablet and follow with a full glass of water.
c. chew the tablet and follow with a full glass of water.
d. swallow the tablet and take nothing else by mouth.

 

 

 

  1. The client has been ordered Marinol for chemotherapy-induced nausea. In planning the dosage schedule for the drug, the nurse recognizes that the medication will be administered:
a. before the chemotherapeutic agent is given.
b. after the chemotherapeutic agent is given.
c. both before and after the chemotherapeutic agent is given.
d. 24 hours before giving the chemotherapy.

 

 

 

 

  1. The client will be taking scopolamine (Transderm-Scop) in his home setting for prevention of motion sickness. In teaching the client how to properly administer the medication, what is the nurse’s highest priority instruction?
a. Two patches can be worn at the same time for overwhelming symptoms.
b. The patch should be applied behind the ear at least 4 hours before the journey.
c. The patch can be worn for as long as 10 days and still be effective.
d. The client should wash his hands before applying the patch.

 

 

 

 

  1. The client takes Metamucil at 9:00 PM. She should expect the onset of action of the drug at between ________ the next day.
a. 7 AM and 9 PM
b. 5 AM and 7 PM
c. 9 AM and 12 midnight
d. 5 AM and 10 PM

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 48: Antiulcer Drugs

 

Test Bank

 

MULTIPLE CHOICE

 

  1. The client asks the nurse if she needs to change her diet now that she is being treated with antacids. The nurse instructs her that because of her treatment regimen she should avoid drinking:
a. apple juice.
b. grape juice.
c. milk.
d. orange juice.

 

 

 

  1. A client is ordered to receive Mylanta II. The nurse is aware that the ideal timing for taking this medication is:
a. with each meal.
b. 1 half-hour before meals.
c. 1 to 3 hours after meals.
d. upon arising and at bedtime.

 

 

 

  1. The client has been ordered treatment with Sucralfate. The nurse recognizes that what is the most optimal dosage schedule for the drug?
a. 7:00 AM, 11:00 AM, 4:00 PM, and 9:00 PM
b. 8:00 AM, 12:00 noon, 5:00 PM, and 10:00 PM
c. 9:00 AM, 1:00 PM, 6:00 PM, and 11:00 PM
d. 10:00 AM, 2:00 PM, 7:00 PM, and 12:00 midnight

 

 

 

  1. A client took Amphojel (aluminum hydroxide). The nurse will instruct the client to monitor for what type of GI disturbance?
a. Nausea and vomiting
b. Anorexia
c. Diarrhea
d. Constipation

 

 

 

  1. The client has been ordered treatment with lansoprazole. The client is being treated for a duodenal ulcer. Because the drug is being used to treat this condition, the nurse anticipates that the client will be ordered:
a. 15 mg daily as maintenance.
b. 30 mg daily for 8 weeks.
c. 15 mg daily for 4 weeks.
d. 30 mg twice daily for 2 weeks.

 

 

 

  1. The client has been ordered treatment with lansoprazole. He is also being treated with theophylline. The combination of the two drugs will result in a(n) _____ in the level of _____.
a. increase; theophylline
b. decrease; theophylline
c. increase; lansoprazole
d. decrease; lansoprazole

 

 

 

  1. When administering Mylanta II and ranitidine (Zantac), when does the most optimal administration of both drugs take place?
a. At regular intervals
b. 1 to 2 hours apart
c. At the same time
d. 12 hours apart

 

 

 

  1. Ranitidine’s (Zantac’s) half-life is 8 to 12 hours. The most appropriate dosing schedule is _____ day.
a. once a
b. twice a
c. four times a
d. every other

 

 

 

  1. A client complains of flatulence, belching, and abdominal distention. What is the most appropriate drug to use to treat these symptoms?
a. Promethazine (Phenergan)
b. Ondansetron (Zofran)
c. Ranitidine (Zantac)
d. Simethicone (Mylicon)

 

 

 

  1. The client has been started on a regimen that includes ranitidine. She complains to the nurse of experiencing depression. The highest priority nursing intervention is to call the physician because this is _______ the medication.
a. an adverse reaction to
b. indicative of a toxic dose of
c. indicative of an anaphylactic reaction to
d. an expected side effect of

 

 

 

  1. A client is ordered to receive a magnesium-based antacid. The nurse should monitor most closely for:
a. diarrhea.
b. constipation.
c. flatulence.
d. belching.

 

 

 

  1. The client has been started on a treatment regimen that includes Amphojel as an antacid. The nurse plans what dosage schedule?
a. 7:00 AM, 11:00 AM, 4:00 PM, and 9:00 PM
b. 8:00 AM, 12:00 noon, 5:00 PM, and 10:00 PM
c. 9:00 AM, 1:00 PM, 6:00 PM, and 9:00 PM
d. 10:00 AM, 2:00 PM, 7:00 PM, and 12:00 midnight

 

 

 

  1. The client has been started on a treatment regimen that includes Amphojel to treat hyperphosphatemia. The nurse plans a dosage schedule of ________ meals.
a. 2 to 3 times daily between
b. 2 to 3 times daily with
c. 3 to 4 daily between
d. 3 to 4 times daily with

 

 

 

  1. The nurse is preparing to administer a dose of Tagamet IV. The nurse should plan to prepare the drug by diluting it in _____ mL of solution.
a. 25
b. 50
c. 100
d. 250

 

 

 

  1. The client has been ordered to be treated with belladonna tincture. Which aspect of the client’s history would cause the nurse to contact the physician?
a. Urinary retention
b. Anxiety
c. Pancreatitis
d. Peptic ulcer

 

 

 

  1. The client is being treated with a histamine2 blocker medication. In implementing diet planning, the nurse should instruct the client to consume a diet that is rich in vitamin:
a. A.
b. B12.
c. C.
d. D.

 

 

 

  1. The client is being treated with cimetidine as well as with Coumadin. The nurse anticipates that the action of the two drugs will produce a(n) _____ in the level of _____.
a. increase; cimetidine
b. decrease; cimetidine
c. increase; Coumadin
d. decrease; Coumadin

 

 

 

  1. The client is being treated with cimetidine. The nurse anticipates a change in the client’s laboratory values of increased:
a. magnesium and phosphorus.
b. calcium and sodium.
c. BUN and creatinine.
d. glucose and cholesterol.

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 49: Drugs for Eye and Ear Disorders

 

Test Bank

 

MULTIPLE CHOICE

 

  1. A client has increased intraocular pressure, and pilocarpine (Isopto Carpine, Pilopine HS, others) has been ordered. The nurse needs to review the medical history because this drug would be contraindicated for the client with:
a. asthma.
b. cardiovascular disease.
c. kidney disease.
d. ulcer disease.

 

 

 

  1. As part of client teaching about miotics, the nurse describes the symptoms indicative of drug toxicity. The highest priority nursing intervention when systemic toxicity is suspected after the client has been treated with a miotic medication is to administer.
a. cascara.
b. calcium gluconate.
c. demecarium bromide.
d. atropine sulfate.

 

 

 

  1. A client is using the ocular therapeutic system. She tells the nurse that she typically changes the Ocusert every 10 days to save money. What is the most accurate response from the nurse?
a. “This practice will allow you to achieve a more therapeutic response from your medication.”
b. “This practice is not recommended, but is allowable under the circumstances.”
c. “This practice is not acceptable because the Ocusert should be applied at bedtime nightly.”
d. “This practice is not acceptable because the Ocusert should be changed every 7 days.”

 

 

 

  1. The nurse is completing a health history on a client who is scheduled to be treated with cyclopentolate (Cyclogyl). Which finding would cause the nurse to contact the physician?
a. Parkinsonism
b. Pregnancy
c. Asthma
d. Glaucoma

 

 

 

  1. What would be an indication of a positive outcome for the client who is receiving treatment with a topical anesthetic for a disorder of the eye?
a. Absence of the blink reflex
b. Moist corneal epithelium
c. No need for a patch over the eye
d. Presence of corneal anesthesia for at least 4 hours

 

 

 

  1. A client who is 10 years old has an infection of the external ear and is being treated with polymyxin B and hydrocortisone. The nurse anticipates that the client will need an additional medication to relieve:

 

a. edema.
b. itching.
c. redness.
d. pain.

 

 

 

  1. A 9-month-old client enters the emergency department carried by his parent. The parent states, “He is fussy and won’t eat. He feels hot and is pulling at his ears.” Acute otitis media (OM) is diagnosed. What is the first-line drug for treatment of middle ear infection?
a. Acetyl sulfisoxazole (Gantrisin)
b. Amoxicillin (Amoxil, Augmentin)
c. Erythromycin (E-Mycin)
d. Cefaclor (Ceclor)

 

 

 

  1. Which nursing intervention would be the highest priority to prevent systemic absorption of eye drops?
a. Apply the drops in the outer canthus of the eye.
b. Have the patient perform the Valsalva maneuver during administration.
c. Have the patient close the eyes for 2 minutes after instillation.
d. Apply pressure to the lacrimal duct after administration.

 

 

 

  1. A client is to be treated with a carbonic anhydrase inhibitor as a means to decrease intraocular pressure. What priority instruction should be included in the nurse’s teaching plan?
a. Allow 5 to 10 minutes after instillation before using another medication.
b. Provide strict fluid restrictions at all times.
c. Provide environmental safety and seizure precautions.
d. Encourage the client to sit in sunlight to enhance metabolism of the drug.

 

 

 

  1. The client is an African American who has been diagnosed with glaucoma. The nurse anticipates that which medication will be most effective for this client?
a. Latanoprost (Xalatan)
b. Bimatoprost (Lumigan)
c. Travoprost (Travatan)
d. Unoprostone (Rescula)

 

 

 

  1. The client is scheduled for ophthalmic surgery. She tells the nurse that she typically self-medicates with herbs for various ailments in the home setting. What is the most accurate response from the nurse?
a. “Herbal therapy may actually intensify any discomfort from the surgery.”
b. “Any herbal therapy must be discontinued before the client undergoes surgery.”
c. “Herbal therapy may lead to a better surgical outcome for the client.”
d. “Any herbal therapy that has been started before surgery should be continued.”

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 50: Drugs for Dermatologic Disorders

 

Test Bank

 

MULTIPLE CHOICE

 

  1. A client is diagnosed with acne. The client expresses concern to the nurse that he has not yet been placed on medication. The nurse explains to the client that the initial nonpharmacologic approach for treating acne vulgaris includes:
a. application of large doses of vitamin A.
b. application of large doses of vitamin C.
c. cleansing of the skin gently several times a day.
d. vigorously scrubbing skin in the morning and at bedtime.

 

 

 

 

  1. The client has been placed on tetracycline (Sumycin) for acne control. In planning a dosage schedule, the nurse anticipates that the client will be taking:
a. low doses over a period of months.
b. low doses for 3 to 4 weeks.
c. high doses for 10 days to 2 weeks.
d. high doses for at least 1 year.

 

 

 

  1. Photosensitivity is a major complication of tetracycline (Sumycin). In providing client teaching, the nurse should suggest that the client ________ while on the medication.
a. avoid direct sunlight
b. wear a hat and long sleeves in the sun
c. use a tanning bed only with supervision
d. use a suntan lotion with a high SPF

 

 

 

  1. The client is being treated extensively with silver nitrate cream. The nurse plans to closely monitor the client’s level of:
a. calcium.
b. sodium.
c. potassium.
d. magnesium.

 

 

 

  1. Upon assessment of the burned client, the nurse notes that the client is exhibiting mottled, blistered skin and is complaining of intense pain. These findings are congruent with which degree of burn injury?
a. First
b. Second
c. Third
d. Fourth

 

 

 

  1. Methoxsalen (Oxsoralen) is a drug used for the treatment of psoriasis. Clients using this agent should not be in direct sunlight for which reason?
a. Skin could become lightened or blanched.
b. Psoriasis would spread.
c. Exposed skin would burn or blister.
d. Skin would become sensitive to light.

 

 

 

  1. A client enters the healthcare provider’s office with complaints of verruca vulgaris (warts). What is the most accurate instructional point to include in a client teaching session?
a. Warts can become malignant after 1 to 2 years and thus must be monitored closely.
b. The only effective means of wart removal is by surgical excision.
c. Drug therapy to remove a common wart may include systemic side effects.
d. Electrodesiccation can be used to eradicate the common warts.

 

 

 

  1. Contact dermatitis may be caused by chemical or plant irritation. What nonpharmacologic measure may aid in alleviating the problem?
a. Determining causative agent
b. Cleansing the skin area immediately
c. Wearing protective gloves or clothing
d. Applying a sterile dressing over the involved area

 

 

 

 

  1. The client is being treated with clobetasol propionate (Clobex). In scheduling the client’s next appointment with the primary care provider, the nurse recognizes that the client’s lesions need to be reassessed in _____ weeks.
a. 2
b. 4
c. 6
d. 8

 

 

 

  1. The client is being treated with etretinate (Tegison, Soriatane). She has been using the medication for 6 weeks and is concerned because she has not seen an improvement in her symptoms. The most accurate response from the nurse is that it may be _____ months for the client to notice an improvement in her symptoms.
a. 2
b. 8
c. 4
d. 6

 

 

 

  1. The nurse plans to monitor a client with second-degree burns for which adverse reaction to mafenide acetate (Sulfamylon)?
a. Increased intraocular pressure
b. Urinary retention
c. Fluid retention
d. Superinfection

 

 

 

  1. Silver sulfadiazine (Silvadene) is used for the treatment of second- and third-degree burns. The highest priority nursing intervention related to this drug is to monitor for:
a. crystalluria.
b. dehydration.
c. headaches.
d. hypertension.

 

 

 

  1. A client is ordered to receive isotretinoin. What is a priority diagnostic test for the nurse to complete before beginning therapy?
a. Blood glucose level
b. Pregnancy test
c. Serum electrolytes
d. Complete blood count

 

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 51: Endocrine Drugs: Pituitary, Thyroid, Parathyroid, and Adrenal Disorders

 

Test Bank

 

MULTIPLE CHOICE

 

  1. The client is being treated with growth hormone. During treatment, the nurse monitors the client closely for evidence of:
a. diabetes mellitus.
b. gastrointestinal distress.
c. hypotension.
d. dwarfism.

 

 

 

  1. A client is noted to have Cushing syndrome. The highest priority nursing intervention related to the client’s electrolyte levels is to monitor for evidence of:
a. sodium retention.
b. water depletion.
c. hypocalcemia.
d. hyperkalemia.

 

 

 

  1. The nurse teaches the client the signs and symptoms of hypothyroidism. The client is taught to self-monitor closely for:
a. tachycardia.
b. palpitations.
c. intolerance to heat.
d. weight gain.

 

 

  1. Client teaching on proper administration of a thyroid replacement drug includes which instruction?
a. Advise the client to report symptoms of hypothyroidism.
b. Instruct the client to take the drug at the same time each day.
c. Instruct the client to eat foods that inhibit thyroid secretion.
d. Teach the client to take the medication on a full stomach.

 

 

 

  1. The client is being treated with a glucocorticoid medication. The nurse plans to monitor him closely for evidence of:
a. hypertension.
b. hypoglycemia.
c. hypovolemia.
d. hyperkalemia.

 

 

 

  1. The healthcare provider left an order to discontinue prednisone (Deltasone, Meticorten, Orasone, others). The highest priority action for the nurse is to:
a. contact the healthcare provider to determine a tapering schedule.
b. explain to the client that the drug will be immediately stopped.
c. contact the pharmacist to determine a tapering schedule.
d. begin gradually decreasing the prednisone dose.

 

 

 

  1. Health teaching for the client receiving prednisone (Deltasone, Meticorten, Orasone, others) to decrease the inflammatory effects related to arthritis includes which instruction?
a. Instruct the patient that the dose can be stopped as needed.
b. Advise the patient to avoid foods rich in potassium.
c. Inform the patient that prednisone should be taken between meals and without food.
d. Teach the client the signs and symptoms of excessive use of glucocorticoids.

 

 

  1. A client is found to be deficient in a mineralocorticoid. The nurse assesses the client for manifestation of this deficiency by noting evidence of:
a. hypotension.
b. hypertension.
c. bradycardia.
d. edema.

 

 

 

  1. A school-aged client with growth hormone (GH) deficiency is recommended for growth hormone injections. What in the client’s history would warrant contacting the primary healthcare provider?
a. Asthma
b. Obesity
c. Apnea
d. Seizure disorder

 

 

 

  1. A client sustains a brain injury. The client is being treated with desmopressin acetate. What would indicate a positive outcome from the medication?
a. Reduction in urine output
b. Increase in urine output
c. Decrease in reabsorption of water in the renal tubules
d. Elevation of the client’s heart rate

 

 

 

  1. The nurse provides medication instructions to a client prescribed liothyronine sodium (Cytomel) for treatment of hypothyroidism. Which symptoms should the client be taught to monitor for that will indicate an overaccumulation of this drug?
a. Dry mouth and lack of ability to urinate
b. Rapid or racing heat rate
c. Lethargy and fatigue
d. Nausea and constipation

 

 

 

  1. The client is being treated with prednisone. Her treatment regimen includes estrogen replacement therapy. The nurse anticipates that the interaction of the two medications will result in:
a. increased effects from the estrogen.
b. increased effects from the prednisone.
c. an anaphylactic reaction.
d. toxicity from the prednisone dosage.

 

 

 

  1. The client is being treated with prednisone. His treatment regimen includes aspirin. The nurse anticipates that the interaction of the two medications will result in _____ toxicity.
a. cardiac
b. genitourinary
c. gastrointestinal
d. respiratory

 

 

 

  1. The client is being treated with calcitriol. Her treatment regimen includes thiazide diuretics. The highest priority nursing intervention based on this drug interaction is to monitor serum _____ level.
a. calcium
b. potassium
c. sodium
d. magnesium

 

 

 

  1. The client is being treated with calcitriol. He complains of changes in his vision. The nurse recognizes that this symptom is most likely ________ the medication.
a. an anaphylactic reaction to
b. indicative of a toxic dosage of
c. an adverse reaction to
d. a side effect of

 

 

 

  1. The client is scheduled to be treated with corticotropin. Which aspect of her client history would cause the nurse to contact the primary healthcare provider?
a. Peptic ulcer
b. Arthritis
c. Glaucoma
d. Dysphagia

 

 

 

  1. The client is being treated with potassium iodide. In instructing the client on self-administration of the medication, what is the highest priority nursing instruction?
a. Drink the medication at room temperature.
b. Swallow the medication in the form of a wafer.
c. Sip the medication through a straw.
d. Chew the tablets thoroughly before swallowing.

 

 

 

  1. Dietary instructions for the client who is being treated with glucocorticoids includes eating a diet high in:
a. vitamin A.
b. potassium.
c. iron.
d. magnesium.

 

 

 

  1. The client is an older adult who is being treated with a glucocorticoid medication. The highest priority nursing intervention with this client is to monitor for evidence of:
a. cardiac dysrhythmias.
b. visual disturbances.
c. cognitive deterioration.
d. increased osteoporosis.

 

 

 

  1. The client is being treated with thyroid replacement therapy. What is the highest priority nursing instruction regarding dietary requirements?
a. Avoid eating shellfish.
b. Avoid eating steak.
c. Increase intake of spinach.
d. Increase intake of strawberries.

 

 

 

MULTIPLE RESPONSE

 

  1. A client is diagnosed with hypothyroidism. What is characteristic of this condition? (Select all that apply.)
a. Constipation
b. Vomiting
c. Bradycardia
d. Weight gain
e. Racing heart beats
f. Irregular menses
g. Intolerance to heat

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 52: Antidiabetics

 

Test Bank

 

MULTIPLE CHOICE

 

  1. The nurse is teaching the client the proper procedure for administration of insulin. The nurse should direct the client to use a _____ syringe.
a. 2-mL
b. 5-mL
c. 40-unit insulin
d. 100-unit insulin

 

 

 

  1. A client’s insulin is administered at 7:00 AM daily. The client is to receive regular and NPH (Humulin N) insulins. The nurse is teaching the client how to prepare the syringe before injection. In preparing the syringe, the client should be taught to:
a. withdraw each medication in a separate syringe.
b. draw up regular insulin first.
c. draw up NPH insulin first.
d. recognize that order of medication withdrawal is not a priority.

 

 

 

  1. In administering an insulin injection to a client, the nurse anticipates that the injection of NPH (Humulin N) and regular (Humulin R) insulins will be administered via the _____ route.
a. intradermal
b. subcutaneous
c. intramuscular
d. intravenous

 

 

 

  1. The nurse is monitoring a client for evidence of a hypoglycemic reaction. The client received Humulin R insulin at 7 AM. The nurse anticipates that the client will need to be most closely monitored for evidence of a hypoglycemic reaction at which time?
a. 9:00 AM to 11:00 AM
b. Noon to 3:00 PM
c. 3:00 PM to 6:00 PM
d. 8:00 PM to Midnight

 

 

 

  1. The nurse assesses a client for evidence of hypoglycemic reaction. The highest priority nursing intervention is to assess for:
a. nervousness and tremors.
b. polyuria and polydipsia.
c. dry skin.
d. extreme thirst.

 

 

 

  1. The nurse notes an order for insulin to be administered intravenously. The nurse recognizes that which insulin is the only type that can safely be administered intravenously?
a. Regular (Humulin R)
b. Lente (Humulin L)
c. NPH (Humulin N)
d. Insulin glargine (Lantus)

 

 

 

  1. The best candidate for treatment with a combination insulin such as Humulin 70/30 is the client who:
a. can use the prepared amount of regular and NPH units.
b. can adjust the amount of regular and NPH dosages.
c. has difficulty mixing insulins.
d. needs to learn how to administer insulins.

 

 

 

  1. A client is ordered to receive insulin glargine (Lantus) insulin. The nurse plans the client’s care based on the fact that Lantus:
a. does not peak.
b. is less expensive.
c. is short acting.
d. requires multiple injections per day.

 

 

 

  1. The client is ordered to be treated with glargine (Lantus) insulin. Because of the type of insulin that the client is receiving, the nurse plans a dosage schedule that administers the medication at which time(s)?
a. 7:00 AM
b. 7:00 AM and 11:00 AM
c. 11:00 AM and 9:00 PM
d. 9:00 PM

 

 

 

  1. The client is scheduled to begin treatment with Metformin. The nurse plans to closely monitor which laboratory values?
a. Cardiac enzymes
b. Liver function tests
c. Complete blood count
d. Respiratory function tests

 

 

 

  1. The client is being treated with Humulin N. She also takes an oral contraceptive. The nurse anticipates that the interaction of these two medications will result in which effect?
a. Anaphylactic reaction
b. Increased effect from the Humulin N
c. Decreased effect from the Humulin N
d. Neurological damage

 

 

 

  1. The best candidate for oral antidiabetic therapy is the client who:
a. has a fasting glucose level of 180 mg/dl.
b. has had a diagnosis of diabetes for 10 years.
c. is 10 pounds under his optimal body weight.
d. requires 60 units of insulin per day.

 

 

 

  1. The client has been started on Metformin (Glucophage). What would be a positive outcome for this client as a result of the medication he is taking?
a. Increased serum glucose level following a meal
b. Decreased serum glucose level following a meal
c. Increased absorption of glucose form the small intestine
d. Reduced absorption of glucose from the small intestine

 

 

 

  1. The best candidate for treatment with Diazoxide (Proglycem) is the client who is experiencing:
a. a hypoglycemic reaction.
b. diabetic ketoacidosis.
c. hypoglycemia caused by hyperinsulinism.
d. insulin resistance reaction.

 

 

 

  1. A client with type 2 diabetes mellitus is admitted to the hospital with an infection. The client was taking oral hypoglycemic agents and is prescribed insulin in the hospital. What is the highest priority instruction that the nurse can give the client regarding insulin administration?
a. Once the client begins to take insulin, she will always be on insulin.
b. Infection temporarily increases the need for insulin.
c. Hospitalized clients are always prescribed insulin.
d. Oral hypoglycemics tend to interact with antibiotics.

 

 

 

  1. A client is to receive Humalog (Lispro) insulin at breakfast. The nurse plans to administer the insulin _____ breakfast.
a. 30 minutes before
b. 5 minutes before
c. with
d. after

 

 

  1. A client is found unconscious with a Medic-Alert bracelet indicating type 1 diabetes mellitus. What is the highest priority nursing intervention?
a. Administer insulin.
b. Feed the client orange juice.
c. Administer glucagon.
d. Perform CPR.

 

 

  1. The client is being treated with Metformin. He is also receiving furosemide. The nurse anticipates that the interaction of the two medications will result in:
a. acute kidney failure.
b. potentiated hypoglycemia.
c. dawn phenomenon.
d. potentiated hyperglycemia.

 

 

 

  1. The client is being treated with Glipizide. She begins to exhibit difficulty breathing. The nurse recognizes that this may be indicative of a(n) ________ the medication.
a. expected side effect of
b. anaphylactic reaction to
c. symptom that is not related to
d. life-threatening reaction to

 

 

 

  1. The client is being treated with rosiglitazone maleate (Avandia). The highest priority instruction to the client based on treatment with this medication is for the client to:
a. increase the intake of calcium.
b. use birth control.
c. keep a food diary.
d. use a respiratory inhaler.

 

 

 

OTHER

 

  1. A client is ordered to receive insulin subcutaneously. What is the order of administration?
  2. Draw up the insulin.
  3. Clean the skin with alcohol.
  4. Insert the needle.
  5. Count to five.
  6. Pinch the skin.
  7. Remove the needle.
  8. Inject the medication.
  9. Verify the doctor’s ordered dosage.

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 53: Female Reproductive Cycle I: Pregnancy and Preterm Labor Drugs

 

Test Bank

 

MULTIPLE CHOICE

 

  1. The client has been prescribed Doxylamine (Unisom) for treatment of nausea and vomiting during pregnancy. What aspect of the client’s history will cause the nurse to contact the primary health care provider?
a. Arthritis
b. Depression
c. Asthma
d. Hyperglycemia

 

 

 

  1. The nurse is teaching a group of pregnant women the importance of adequate nutrition for the fetus. The nurse instructs the clients that folic acid deficiency during preconception and early in pregnancy can result in:
a. skeletal defects.
b. neural tube defects.
c. intrauterine growth retardation.
d. small-for-gestational-age infants.

 

 

 

  1. A client is ordered to receive iron and antacids. The nurse teaches the client that iron and antacids should be administered:
a. at the same time.
b. 2 hours apart.
c. with the antacid first.
d. with the iron first.

 

 

 

  1. A client, 10 weeks pregnant, complains of severe nausea of pregnancy. Meclizine (Bonine) is prescribed. The client reports to the nurse that she has begun to experience dizziness. What is the highest priority nursing intervention?
a. Contact the pharmacist; this indicates an overdosage of the medication.
b. Contact the physician; this is an expected side effect of the medication.
c. Contact the pharmacist; this indicates incorrect preparation of the medication.
d. Contact the physician; this is an adverse reaction to the medication.

 

 

 

  1. A client complains of severe pregnancy-related nausea and is placed on Meclizine (Bonine). The nurse notes in the client history that the client is undergoing treatment for glaucoma. What is the highest priority nursing intervention?
a. Recognize that one of the off-label uses for the drug is treatment of glaucoma.
b. Contact the pharmacist; the dosage of the drug should be decreased when glaucoma is present.
c. Recognize that use of the drug when glaucoma is present may result in a fatal reaction.
d. Contact the physician; the drug should be used with caution when glaucoma is present.

 

 

 

  1. Betamethasone (Celestone) is ordered for a client in preterm labor. The client asks the nurse what the medication will do to help her. The nurse explains to the client that the medication will:
a. help her to breathe more effectively during the labor process.
b. prevent her infant from developing respiratory distress syndrome.
c. help her infant to breathe more effectively during the labor process.
d. prevent her from developing congestive heart failure during labor.

 

 

 

  1. A client is admitted to the labor and delivery unit and is being treated with terbutaline (Brethine). The nurse plans the client’s care with the knowledge that this medication is used to:
a. induce labor.
b. decrease uterine contractions.
c. stimulate fetal heart rate.
d. enhance placental blood flow.

 

 

 

  1. The client is being treated with hydralazine hydrochloride (Apresoline). What would be a positive outcome for the client as a result of treatment with this medication?
a. Diastolic BP is maintained between 90 and 110 mm Hg.
b. Diastolic BP is maintained between 70 and 90 mm Hg.
c. Systolic BP is maintained between 100 and 120 mm Hg.
d. Systolic BP is maintained between 90 and 110 mm Hg.

 

 

 

  1. A client diagnosed with pregnancy-induced hypertension (PIH) is treated with magnesium sulfate. The nurse tells the client that the purpose of this treatment is to:
a. prolong labor.
b. prevent seizures.
c. increase blood pressure.
d. stimulate urination.

 

 

 

  1. A prenatal client discloses that she takes high doses of vitamins. Which is the most accurate instruction that the nurse can provide in response to the client’s statement?
a. “High levels of vitamins may cause harm to the fetus.”
b. “Only water-soluble vitamins may be harmful during pregnancy.”
c. “Megadoses of vitamins are associated with positive birth outcomes.”
d. “Vitamin supplementation is not needed during pregnancy.”

 

 

 

  1. A pregnant woman experiences constipation. The nurse anticipates that which laxative may be used first after activity and dietary methods are unsuccessful?
a. Mineral oil
b. Psyllium (Metamucil)
c. Lactulose
d. Milk of magnesia

 

 

 

  1. The client is scheduled for treatment with betamethasone (Celestone). The nurse anticipates that this medication will be administered via the _____ route.
a. oral
b. intravenous
c. intramuscular
d. subcutaneous

 

 

 

  1. The client is scheduled for treatment with betamethasone (Celestone). The nurse anticipates that the medication will be administered to the client during which week _____ or before of her pregnancy.
a. 38
b. 36
c. 35
d. 33

 

 

 

MULTIPLE RESPONSE

 

  1. A young women in labor, G1P0, is diagnosed with pregnancy-induced hypertension (PIH). She is ordered to receive magnesium sulfate. What are the other components of her nursing care? (Select all that apply.)
a. Maintaining a quiet environment
b. Assessing vital signs and fetal heart tones frequently
c. Providing large amounts of PO and IV fluids to maintain fluid volume
d. Allowing the woman to ambulate ad lib
e. Assessing for clonus and deep tendon reflexes
f. Monitoring urine hourly for protein

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 54: Female Reproductive Cycle II: Labor, Delivery, and Preterm Neonatal Drugs

 

Test Bank

 

MULTIPLE CHOICE

 

  1. The healthcare provider orders hydroxyzine (Vistaril) for a client in labor. To achieve a positive outcome, the nurse plans to administer the drug via which route?
a. Intradermally
b. Intravenously
c. Intramuscularly via Z-track technique
d. Subcutaneously via Z-track technique

 

 

 

  1. An epidural block is ordered for a primipara client in labor. The nurse anticipates that this epidural block will be given when the cervix is dilated at _____ centimeters.
a. 2 to 3
b. 3 to 4
c. 4 to 5
d. 5 to 6

 

 

 

  1. A client is being treated with an ergot alkaloid medication. Which observation would cause the nurse to contact the primary healthcare provider?
a. Hypertension
b. Itching
c. Jugular vein distention
d. Seizure activity

 

 

 

  1. What would be a positive outcome of administration of oxytocin (Pitocin) 10 units (intramuscularly) after the third stage of labor?
a. Relaxation of the uterus
b. Relief of “afterbirth” discomfort
c. Suppression of lactation
d. Prevention of uterine atony

 

 

 

  1. The client is scheduled for an epidural anesthetic as she delivers. What will be the highest priority nursing intervention?
a. Administer 1 L of an isotonic IV solution and encourage use of a bedpan after spinal anesthesia.
b. Administer 500 mL of a hypotonic IV solution and assess the level of consciousness because the patient is sedated.
c. Administer 500 mL of a hypertonic IV solution and assess fetal heart rate and progress of labor as per pregnancy protocol.
d. Administer 1 L of hypotonic IV solution and allow the client to ambulate during the spinal anesthesia.

 

 

 

  1. The best candidate for induction of labor is the woman:
a. experiencing a multiple gestation pregnancy.
b. experiencing umbilical cord prolapse.
c. whose fetus will probably be premature.
d. who fetus is post due date.

 

 

 

  1. The best candidate for treatment with dinoprostone (Cervidil) is the woman who needs her:
a. labor stopped.
b. cervix ripened.
c. labor stimulated.
d. labor prolonged.

 

 

 

  1. Which will most likely be part of the nursing care of a woman postcaesarean section with spinal anesthesia?
a. Early ambulation to avoid constipation
b. Fluid restrictions to decrease blood volume
c. Lying flat 6 to 8 hours to avoid spinal headache
d. IV antibiotics to avoid postpartum infection

 

 

 

  1. The client is scheduled to be treated with Oxytocin by nasal spray. The nurse plans to administer the drug:
a. 2 to 3 minutes after the client nurses her baby.
b. 2 to 3 minutes before the client nurses her baby.
c. after delivery of the placenta.
d. as delivery of the placenta is imminent.

 

 

 

  1. The client received a score of 9 on the Modified Bishop Scoring System. The nurse interprets this to mean that the client:
a. cannot be considered for labor induction because of to her overall health status.
b. can be considered for labor induction but the risks should be evaluated.
c. cannot be considered for labor induction due to the risks to the fetus.
d. can be considered for a labor induction, which is anticipated to be successful.

 

 

 

MULTIPLE RESPONSE

 

  1. A gravida 3, para 2 woman at 41 weeks’ gestation is 1 cm dilated and 60% effaced. She has not ruptured her membranes, has not passed a mucus plug, and is not experiencing labor. It is decided that if she does not experience labor by the next day, she will be induced with oxytocin (Pitocin). Which actions are key to the nursing care of a woman experiencing induction? (Select all that apply.)
a. Provide an explanation of all procedures to the client.
b. Monitor mother’s vital signs throughout the procedure.
c. Insert and monitor arterial blood pressure via an inserted arterial line.
d. Continuously monitor fetal toleration to the induction.
e. Insert a Foley catheter and monitor hourly urine outputs.
f. Assess for obstetric complications and notify physician as warranted.
g. Monitor the intravenous infusion of medication.
h. Continue to increase dosage, titrating until fetal distress is marked.

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 55: Postpartum and Newborn Drugs

 

Test Bank

 

MULTIPLE CHOICE

 

  1. A client complains of constipation during the postpartum period. Which nursing intervention would be highest priority to include in the client’s plan of care?
a. Drink 3 to 4 glasses of fluid per day.
b. Limit activity.
c. Eat beans or cabbage.
d. Avoid using laxatives for longer than a week.

 

 

 

  1. The nurse is caring for a newborn immediately after birth. The highest priority nursing intervention to prevent bleeding is to:
a. administer feeding formula that contains iron.
b. order clotting factor studies after birth.
c. wrap the baby in double blankets.
d. administer vitamin K.

 

 

 

  1. The client expresses concern to the nurse about her need for an effective nonpharmacologic measure during the postpartum period to promote bowel function and prevent constipation. What is the nurse’s best recommendation to the client?
a. Rest on left side in bed during the first 6 to 8 hours after delivery.
b. Order cottage cheese on meal tray to promote bowel flora.
c. Drink a minimum of 24 ounces of fluid per day.
d. Do not attempt early defecation because urge sensation can present as referred pain.

 

 

 

  1. The nurse is developing a client teaching session about the use of witch hazel in the postpartum period. What is the most accurate instruction that the nurse can provide?
a. Contact a healthcare provider if perineal discomfort does not improve within 7 days.
b. Warm commercial witch hazel pads to increase analgesic properties.
c. Pour lukewarm liquid witch hazel into a cup and soak gauze squares in solution before application.
d. Insert medicated pads gently into the rectum if hemorrhoids are present.

 

 

 

  1. How should the nurse interpret a rubella titer of 1:6/1:10?
a. The rubella vaccine is likely to cause anaphylactic reaction.
b. The rubella vaccine will likely be ineffective with this client.
c. The client has no need for the rubella vaccine.
d. The client has a need for the rubella vaccine.

 

 

 

  1. Which baby would not be a candidate to receive Rho (D) immune globulin (RhoGAM)?
a. Direct Coombs’ test positive
b. Mother is indirect Coombs’ test negative
c. Rho(D) positive
d. Rho(D) negative

 

 

 

  1. The instruction that would be contraindicated for women with fourth-degree perineal lacerations is to use:
a. topical witch hazel.
b. rectal suppositories.
c. peribottles frequently.
d. sitz baths frequently.

 

 

 

  1. A client is experiencing postpartum discomfort. Three days postpartum, which analgesic will the nurse offer first?
a. Morphine
b. Meperidine
c. Ibuprofen
d. Aspirin

 

 

 

  1. A nurse is teaching a woman about the care of her newborn’s umbilical cord. Which reflects the current recommendations?
a. The use of triple dye
b. Dry cord care
c. The use of alcohol
d. The use of bacitracin ointment

 

 

  1. A woman with a newborn elects not to breastfeed. Which measure will most effectively assist in suppressing her milk supply?
a. Stimulation of the breasts
b. Restriction of fluid intake
c. A supportive bra worn at all times
d. Heat applied to the breasts

 

 

  1. The client is scheduled to be treated with bisacodyl (Dulcolax) to promote postpartum bowel function. What is the most important instruction that the nurse should give the client?
a. Always crush the tablets.
b. Give within 1 hour of drinking milk.
c. Never crush the tablets.
d. Give within 1 hour of taking an antacid.

 

 

 

  1. The client has a perineal wound as a result of a laceration that occurred during the birth process. What is the most accurate nonpharmacologic measure that the nurse teaches the client to use for relief?
a. Warm sitz bath 2 to 3 hours after delivery
b. Cool sitz bath 12 to 24 hours after delivery
c. Client positioned supine or prone
d. Early and frequent ambulation

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 56: Drugs for Women’s Reproductive Health and Menopause

 

Test Bank

 

MULTIPLE CHOICE

 

  1. The client with _____ would not be a candidate for treatment with oral contraceptives.
a. thromboembolic disease
b. asthma
c. gallbladder disease
d. epilepsy

 

 

 

  1. The client is being treated with conjugated estrogen (Prempro). She tells the nurse that she is also taking a tricyclic antidepressant. The nurse anticipates that the interaction of the two drugs may result in a(n):
a. decreased amount of conjugated estrogen.
b. decreased amount of the tricyclic antidepressant.
c. anaphylactic reaction to the medication.
d. toxic level of the medication.

 

 

 

  1. Which would be the highest priority health teaching about serious side effects of oral contraceptives?
a. Severe abdominal pain should be reported.
b. Constipation usually will occur in all clients.
c. Hearing loss has been reported in some clients.
d. Blood clots usually occur only if the client is obese.

 

 

 

  1. The client tells the nurse that she has missed a dose of her progestin-only oral contraceptive. What is the most accurate instruction the nurse should provide?
a. Take one tablet, discard missed tablet, continue schedule, but use secondary form of contraception until menses begin.
b. Take two tablets daily for the next 2 days and resume regular schedule PLUS use a secondary form of contraception for the rest of the cycle.
c. Take tablet as soon as realized and follow with next tablet at regular time PLUS use backup method of contraception for 48 hr.
d. Start a new package of tablets 7 days after the last tablet was taken. Use another form of contraception until tablets have been taken for 7 consecutive days.

 

 

 

  1. The client has been started in hormone replacement therapy with Menostar. The nurse is preparing a client instruction session on the medication and plans it with the knowledge that the drug is administered in the form of a:
a. vaginal ring.
b. matrix pouch.
c. matrix patch.
d. topical emulsion.

 

 

 

  1. A client asks about the birth control known as “the patch.” The nurse plans a client teaching session about this medication with the knowledge that it:
a. is effective for women of all body weights.
b. works continuously, and there are no menstrual periods.
c. is 50% effective in preventing pregnancy.
d. may cause a localized skin reaction.

 

 

 

  1. A client makes various statements related to managing menopausal symptoms. Which statement indicates a need for further teaching?
a. “I know swimming will help prevent osteoporosis.”
b. “I eat a diet high in calcium.”
c. “I try to limit my red meat and sugar.”
d. “I drink only occasional alcohol and caffeine.”

 

 

 

  1. Which client would be at highest risk to develop osteoporosis?
a. Average-sized African-American woman with two children
b. Small-boned Hispanic woman who has had four pregnancies
c. Small-boned Caucasian woman who has no children
d. Average-sized Caucasian woman with one child and two pregnancies

 

 

 

  1. The client tells the nurse that she has stopped spontaneous menstruation as part of the process of menopause. Regarding the need for contraception, what should be the nurse’s highest priority instruction to the client?
a. Contraception is no longer necessary now that periods have stopped.
b. Contraception should be used only if breakthrough bleeding occurs.
c. Contraception should be used for 6 months after cessation of spontaneous menstruation.
d. Contraception should be used until 1 year after cessation of spontaneous menstruation.

 

 

 

  1. The client is scheduled to begin hormone replacement therapy to treat menopausal symptoms. She questions the nurse about the length of time that she should expect to take the medication. The nurse plans a client teaching session with the knowledge that the most effective time period for the client to take the medication will be:
a. for a lifetime.
b. no longer than 5 years.
c. a maximum of 10 years.
d. no longer than 3 years.

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 57: Drugs for Men’s Health and Reproductive Disorders

 

Test Bank

 

MULTIPLE CHOICE

 

  1. The client who ________ would not be a candidate for treatment of erectile dysfunction with yohimbine.
a. is older than 65 years
b. has a history of urinary incontinence
c. is younger than 55 years
d. has a history of cardiac arrhythmia

 

 

 

  1. The client has been started on androgen therapy. As a result of this therapy, the nurse plans to closely monitor which laboratory value?
a. Renal function
b. Blood sugar
c. Hematocrit
d. Cholesterol

 

 

 

  1. The client with a history of _______ would not be a candidate for androgen therapy.
a. renal calculi
b. multiple sclerosis
c. benign prostatic hypertrophy
d. cardiovascular disease

 

 

 

  1. The client who is being treated with androgen therapy is also being treated with insulin. As a result of the interaction of the two drugs, what change in the client’s medication should the nurse anticipate?
a. Increase in androgen dosage
b. Increase in insulin dosage
c. Reduction in insulin dosage
d. Reduction in androgen dosage

 

 

 

  1. The highest priority instruction for a client receiving androgen therapy is to:
a. take androgens with food.
b. avoid alcohol.
c. limit sun exposure.
d. limit fluids.

 

 

 

  1. The best candidate for treatment with antiandrogens is the client who is experiencing:
a. benign prostatic hypertrophy.
b. psoriasis.
c. baldness.
d. urinary retention.

 

 

 

  1. The client has been placed on testosterone therapy and tells the nurse that he is experiencing shortness of breath. The nurse recognizes that this symptom is indicative of a(n) _____ the medication.
a. anaphylactic reaction to
b. adverse reaction to
c. expected side effect of
d. life-threatening reaction to

 

 

 

  1. The client is being treated with the topical form of testosterone. The nurse should teach the client to apply the medication:
a. twice daily to the face.
b. once daily to the shoulders.
c. once daily to the legs.
d. twice daily to the hands.

 

 

 

  1. The client reports that he has been using Cantharides (Spanish fly) as a sexual stimulant. What is the highest priority instruction that the nurse should give the client?
a. Myocardial infarction has been reported from use of this substance.
b. Sudden death has been reported from use of this substance.
c. Permanent penile damage can result from use of this substance.
d. Methemoglobinemia has been reported from use of this substance.

 

 

 

  1. A client is prescribed sildenafil citrate (Viagra) to treat erectile dysfunction, and a nurse is providing teaching regarding the medication. The nurse would instruct the patient that this medication should be administered:
a. every 12 hours.
b. 8 hours before sexual activity.
c. 30 minutes to 4 hours before sexual activity.
d. during sexual activity.

 

 

 

  1. A client is to receive sildenafil citrate (Viagra) for erectile dysfunction. In teaching the client, the nurse discovers that the client is taking nitroglycerin (NTG) prn angina. Which instruction is a priority at this time?
a. Tell the client to take both medications as ordered by the healthcare provider.
b. Tell the client not to take the NTG until 1 hour after a dose of Viagra if angina occurs.
c. Ask the client to watch for signs of postural hypotension, including dizziness.
d. Refer the client to the healthcare provider because taking both medications is contraindicated.

 

 

 

 

MULTIPLE RESPONSE

 

  1. A client with benign prostatic hypertrophy is ordered to receive finasteride (Proscar). To evaluate its effectiveness, the nurse would expect which effects? (Select all that apply.)
a. Increasing nocturia
b. Decreasing frequency in urination
c. Decreasing hesitancy in urination
d. Increasing bladder fullness
e. Rising prostate-specific antigen levels
f. Decreased urine dribbling
g. Normal erectile function

 

 

=

 

Kee: Pharmacology, 7th Edition

 

Chapter 58: Drugs for Disorders in Women’s Health, Infertility, and Sexually Transmitted Infections

 

Test Bank

 

MULTIPLE CHOICE

 

  1. The client elects to receive Gardasil. The client chooses to begin the drug series in January. The nurse plans the client’s schedule of administration, recognizing that which would be the correct time and route for the client to receive the medication?
a. Subcutaneous injections given in January, February, and March
b. Intramuscular injections given in January, March, and June
c. Tablets given in January, March, and May
d. Tablets given in January, February, and March

 

 

 

  1. The client has been diagnosed with syphilis. The infective process for this client is known to be greater than 1 year. Because of the type and length of the infectious process, the nurse anticipates that the type of drug to administer and the time of administration will be:
a. spectinomycin IM once in the early stage of the disease.
b. doxycycline IM once weekly for 3 weeks.
c. probenecid IM once in the early stage of the disease.
d. benzathine penicillin G IM once weekly for 3 weeks.

 

 

 

 

  1. The client has been started on clomiphene citrate (Clomid). She has been taking 50 mg/d of the medication and has not started to ovulate. The nurse plans to discuss with the client the next step in the course of treatment. The highest priority instruction that the nurse should give the client is to expect the physician to:
a.  most likely decrease the dosage.
b. discontinue the medication.
c. most likely increase the dosage.
d. most likely start the client on a second drug.

 

 

 

  1. The client is scheduled to begin treatment with clomiphene citrate (Clomid). Which aspect of the client’s medical history would cause the nurse to contact the primary care provider?
a. Cardiac arrhythmia
b. Fibroid tumors
c. Hypertension
d. Underweight

 

 

 

  1. A client has been receiving treatment with clomiphene citrate (Clomid). She complains to the nurse of experiencing hair loss. What is the highest priority action on the part of the nurse?
a. Explain to the client that this is an expected side effect of the medication.
b. Call the pharmacist; this is indicative of an error in the preparation of the medication.
c. Call the physician; the client is experiencing an anaphylactic reaction to the medication.
d. Call the physician; the client is experiencing an adverse reaction to the medication.

 

 

 

  1. The client is 3 months pregnant and has just been diagnosed with trichomoniasis at the health clinic. She asks the nurse if she should ask her personal physician for a prescription for metronidazole. What is the nurse’s response?
a. “Metronidazole can be used to treat a pregnant woman after the second trimester.”
b. “Metronidazole can be used to treat a pregnant woman if she has no complications.”
c. “Metronidazole can be used to treat a pregnant woman after the first trimester.”
d. “Metronidazole should never be used to treat a pregnant woman.”

 

 

 

  1. The client has been diagnosed with chancrous lesions. In instructing the client about caring for the lesions, what is the nurse’s highest priority instruction?
a. Use compresses to remove the necrotic material.
b. Apply azithromycin ointment to the lesions daily.
c. Do not remove the crust over the lesions.
d. Report any sign of necrosis to the physician.

 

 

 

  1. The client reports experiencing recurrent bouts of candidiasis. The highest priority action on the part of the nurse is to:
a. refer the client to the primary care provider for a medication change.
b. explain to the client that the condition may be difficult to eradicate.
c. determine whether the client is compliant with taking medication.
d. refer the client to the primary care provider for further testing.

 

 

 

  1. The client is being treated with metronidazole. The nurse is preparing an instructional session on dietary restrictions with this drug. What is the highest priority instruction regarding diet?
a. Consume a high-potassium diet during treatment and for 1 month afterward.
b. Consume a low-sodium diet during treatment and for 1 month afterward.
c. Avoid all products containing alcohol during treatment and for 3 days afterward.
d. Avoid all products containing vitamin C during treatment and for 3 days afterward.

 

 

 

  1. The client is being treated with recombinant hCG (Ovidrel) as an ovulatory stimulant. She is concerned about risks that are associated with the drug. The nurse should verify that the client has been instructed by her primary care provider regarding the possibility that:
a. the drug is teratogenic.
b. multiple gestation could occur.
c. the drug is carcinogenic.
d. pregnancy loss could occur.

 

 

 

  1. The client is a devout Catholic and has expressed great anxiety regarding the use of treatment for her infertility. The nurse should plan the client’s care with the knowledge that the Catholic church:
a. supports of the use of reproductive technologies.
b. does not support the use of treatment for anxiety.
c. supports use of reproductive technology for procreation.
d. does not support the use of reproductive technologies.

 

 

 

MULTIPLE RESPONSE

 

  1. Many sexually transmitted infections (STIs) are treated pharmacologically. Which STIs are eradicated using medication therapies? (Select all that apply.)
a. Chlamydia
b. Syphilis
c. HIV/AIDS
d. Herpes simplex virus
e. Gonorrhea
f. Candidiasis
g. Genital warts

 

 

 

Kee: Pharmacology, 7th Edition

 

Chapter 59: Adult and Pediatric Emergency Drugs

 

Test Bank

 

MULTIPLE CHOICE

 

  1. The nurse administers intravenous magnesium sulfate to a client being treated for refractory ventricular fibrillation. The client is experiencing symptoms of deep tendon reflex impairment. The nurse interprets this as being indicative of:
a. magnesium toxicity.
b. hypomagnesemia.
c. expected side effect of the drug.
d. anaphylactic reaction.

 

 

 

  1. The client who has ingested _____ would not be a candidate for treatment with activated charcoal.
a. large amounts of salicylates
b. large amounts of lithium
c. certain types of poisonous mushrooms
d. certain slow-release drug preparations

 

 

 

  1. The client has inadvertently taken an overdose of beta-blockers. The nurse anticipates that the primary healthcare provider will treat this with:
a. epinephrine.
b. glucagon.
c. norepinephrine.
d. dextrose 50%.

 

 

 

  1. The highest priority nursing intervention when administering verapamil (Calan) is to monitor _____ closely.
a. blood pressure
b. heart rate
c. body temperature
d. respiratory rate

 

 

 

  1. The client has overdosed on benzodiazepine medication. Based on the orders of the primary healthcare provider, the highest priority action on the part of the nurse is to prepare a dose of:
a. naloxone.
b. activated charcoal.
c. flumazenil.
d. 50% dextrose.

 

 

 

  1. The client is scheduled to begin treatment with sublingual nitroglycerin to treat angina. A history of medication for ________ would cause the nurse to contact the primary healthcare provider.
a. erectile dysfunction
b. migraine headaches
c. sinus infection
d. coronary artery disease

 

 

 

  1. The client has received a dose of nitroprusside sodium to treat hypertensive crisis. She complains to the nurse of experiencing abdominal pain and nausea. The highest priority action on the part of the nurse is to call the physician because this is ________ the medication.
a. an expected side effect of the
b. an adverse reaction to
c. evidence of a toxic level of the
d. evidence of an anaphylactic reaction to

 

 

 

  1. The client has an IV containing sodium bicarbonate. The nurse is preparing to administer a dose of dopamine. What is the highest priority action on the part of the nurse?
a. Flush the line with normal saline before and after pushing the dopamine.
b. Start a second IV line to use for administration of the dopamine.
c. Turn the IV wide open before pushing the dopamine through it.
d. Explain to the client that he may feel burning while the dopamine infuses.

 

 

 

  1. A client is ordered to receive epinephrine (Adrenalin) to relieve shortness of breath. Which additional effects would the nurse expect?
a. Decrease in respiratory rate
b. Decrease in blood pressure
c. Increase in heart rate
d. Decrease in oxygen saturation

 

 

 

  1. During a prolonged resuscitation effort, a client’s pH is noted to be 7.28. The nurse anticipates that which medication would be administered?
a. Epinephrine (Adrenalin)
b. Atropine
c. Sodium bicarbonate
d. Lidocaine (Xylocaine)